Saw Jacqueline, Holmes David R, Cavalcante João L, Freeman James V, Goldsweig Andrew M, Kavinsky Clifford J, Moussa Issam D, Munger Thomas M, Price Matthew J, Reisman Mark, Sherwood Matthew William, Turi Zoltan G, Wang Dee Dee, Whisenant Brian K
Division of Cardiology, Vancouver General Hospital, University of British Columbia, Canada.
Department of Cardiovascular Medicine, Mayo Clinic Health System Rochester, Rochester, Minnesota.
Heart Rhythm. 2023 May;20(5):e1-e16. doi: 10.1016/j.hrthm.2023.01.007. Epub 2023 Mar 27.
Exclusion of the left atrial appendage to reduce thromboembolic risk related to atrial fibrillation was first performed surgically in 1949. Over the past 2 decades, the field of transcatheter endovascular left atrial appendage closure (LAAC) has rapidly expanded, with a myriad of devices approved or in clinical development. The number of LAAC procedures performed in the United States and worldwide has increased exponentially since the Food and Drug Administration approval of the WATCHMAN (Boston Scientific) device in 2015. The Society for Cardiovascular Angiography & Interventions (SCAI) has previously published statements in 2015 and 2016 providing societal overview of the technology and institutional and operator requirements for LAAC. Since then, results from several important clinical trials and registries have been published, technical expertise and clinical practice have matured over time, and the device and imaging technologies have evolved. Therefore, SCAI prioritized the development of an updated consensus statement to provide recommendations on contemporary, evidence-based best practices for transcatheter LAAC focusing on endovascular devices.
1949年首次通过手术切除左心耳以降低与心房颤动相关的血栓栓塞风险。在过去20年中，经导管血管内左心耳封堵术（LAAC）领域迅速发展，众多设备已获批准或正处于临床研发阶段。自2015年美国食品药品监督管理局批准WATCHMAN（波士顿科学公司）设备以来，美国和全球范围内进行的LAAC手术数量呈指数级增长。心血管造影和介入学会（SCAI）此前曾在2015年和2016年发表声明，对该技术以及LAAC的机构和操作者要求进行了社会层面的概述。自那时以来，多项重要临床试验和注册研究的结果已发表，技术专业知识和临床实践随着时间的推移而成熟，设备和成像技术也不断发展。因此，SCAI将制定一份更新的共识声明作为优先事项，以提供关于以血管内设备为重点的经导管LAAC当代循证最佳实践的建议。
