Diaz Juan Carlos, Duque Mauricio, Marin Jorge, Aristizabal Julian, Niño Cesar, Bastidas Oriana, Matos Carlos D, Hoyos Carolina, Hincapie Daniela, Romero Jorge E
Cardiac Arrhythmia and Electrophysiology Service, Clinica Las Vegas, Universidad CES Medical School Medellin, Colombia.
Cardiac Arrhythmia and Electrophysiology Service, Hospital San Vicente Fundación Rionegro, Colombia.
Arrhythm Electrophysiol Rev. 2024 Mar 12;13:e03. doi: 10.15420/aer.2023.29. eCollection 2024.
Left atrial appendage occlusion (LAAO) is a suitable alternative to oral anticoagulant therapy to prevent stroke in patients with AF. Most procedures are performed under transoesophageal echocardiography (TOE) guidance, which facilitates transseptal puncture, reduces the risk of procedurerelated complications and provides an additional method for device selection and real-time monitoring during device deployment. However, TOE has significant shortcomings, including the need for general anaesthesia/deep sedation as well as a significant risk of procedure-related adverse events. More recently, intracardiac echocardiography has been proposed as an alternative to TOE guidance during LAAO procedures. In this review, we summarise the available evidence as well as providing a step-by-step approach for intracardiac echocardiography-guided LAAO.
左心耳封堵术（LAAO）是预防房颤患者卒中的一种合适的口服抗凝治疗替代方法。大多数手术在经食管超声心动图（TOE）引导下进行，这有助于经房间隔穿刺，降低手术相关并发症的风险，并为设备选择和设备植入期间的实时监测提供了额外的方法。然而，TOE有显著缺点，包括需要全身麻醉/深度镇静以及手术相关不良事件的重大风险。最近，心腔内超声心动图已被提议作为LAAO手术中TOE引导的替代方法。在本综述中，我们总结了现有证据，并提供了心腔内超声心动图引导下LAAO的分步方法。
