Święczkowski Michał, Dąbrowski Emil Julian, Muszyński Paweł, Pogorzelski Piotr, Jemielita Piotr, Dudzik Joanna Maria, Januszko Tomasz, Duzinkiewicz Małgorzata, Południewski Maciej, Kuźma Łukasz, Kożuch Marcin, Kralisz Paweł, Dobrzycki Sławomir
Department of Invasive Cardiology, Medical University of Bialystok, 24A Sklodowskiej-Curie St., 15-276 Bialystok, Poland.
Second Department of Nephrology and Hypertension with Dialysis Unit, Medical University of Bialystok, 24A Sklodowskiej-Curie St., 15-276 Bialystok, Poland.
J Cardiovasc Dev Dis. 2024 Jul 27;11(8):234. doi: 10.3390/jcdd11080234.
Atrial fibrillation (AF) is the most common arrhythmia worldwide, and is associated with a significant risk of thromboembolic events. Left atrial appendage occlusion (LAAO) has emerged as a promising alternative for patients with contraindications or intolerance to anticoagulant therapy. This review summarises the current evidence, indications, and technical advancements in surgical and percutaneous LAAO. Preprocedural planning relies on various imaging techniques, each with unique advantages and limitations. The existing randomised clinical trials and meta-analyses demonstrate favourable results for both percutaneous and surgical LAAO. Postprocedural management emphasises personalised anticoagulation strategies and comprehensive imaging surveillance to ensure device stability and detect complications. Future focus should be put on antithrombotic regimens, investigating predictors of device-related complications, and simplifying procedural aspects to enhance patient outcomes. In summary, LAAO is presented as a valuable therapeutic option for preventing AF-related thromboembolic events, with ongoing research aimed at refining techniques and improving patient care.
心房颤动（AF）是全球最常见的心律失常，并且与血栓栓塞事件的重大风险相关。对于有抗凝治疗禁忌症或不耐受的患者，左心耳封堵术（LAAO）已成为一种有前景的替代方法。本综述总结了外科和经皮左心耳封堵术的当前证据、适应症及技术进展。术前规划依赖于各种成像技术，每种技术都有独特的优势和局限性。现有的随机临床试验和荟萃分析表明，经皮和外科左心耳封堵术均取得了良好的效果。术后管理强调个性化抗凝策略和全面的成像监测，以确保装置稳定性并检测并发症。未来应关注抗栓方案，研究与装置相关并发症的预测因素，并简化手术操作环节以改善患者预后。总之，左心耳封堵术是预防房颤相关血栓栓塞事件的一种有价值的治疗选择，目前正在进行的研究旨在完善技术并改善患者护理。
