Department of Cardiology, Mayo Clinic School of Medicine, Rochester, MN, USA.
Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
EuroIntervention. 2023 Feb 6;18(13):e1038-e1065. doi: 10.4244/EIJ-D-22-00627.
Prevention of stroke represents a goal of primary importance in health systems due to its associated morbidity and mortality. As several patient groups with increased stroke rates have been identified, multiple approaches have been developed and implemented: oral anticoagulation (OAC) for patients with atrial fibrillation, surgical and percutaneous revascularisation in patients with carotid disease, device closure for patients with patent foramen ovale, and now, left atrial appendage occlusion (LAAO) for selected patients with non-valvular atrial fibrillation (NVAF). The latter group of patients are the focus of this review which evaluates the pathophysiology, selection of patients, procedural performance, outcomes of treatment both during and post-procedure, adjunctive therapy, complications, and longer-term outcomes.
预防中风是医疗体系中一个非常重要的目标,因为它与发病率和死亡率相关。由于已经确定了多个中风风险增加的患者群体,因此已经开发并实施了多种方法:房颤患者的口服抗凝治疗(OAC)、颈动脉疾病患者的手术和经皮血运重建、卵圆孔未闭患者的器械闭合,以及现在,对于特定的非瓣膜性心房颤动(NVAF)患者,采用左心耳封堵术(LAAO)。本综述的重点是后一组患者,评估了病理生理学、患者选择、手术操作、治疗期间和治疗后的结果、辅助治疗、并发症和长期结果。