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左心耳封堵术的现状

State of the Art in Left Atrial Appendage Occlusion.

作者信息

Garg Jalaj, Kabra Rajesh, Gopinathannair Rakesh, Di Biase Luigi, Wang Dee Dee, Saw Jacqueline, Hahn Rebecca, Freeman James V, Ellis Christopher R, Lakkireddy Dhanunjaya

机构信息

Division of Cardiology, Cardiac Arrhythmia Service, Loma Linda University Health, Loma Linda, California, USA.

Kansas City Heart Rhythm Institute and Research Foundation, Kansas City, Kansas, USA.

出版信息

JACC Clin Electrophysiol. 2025 Mar;11(3):602-641. doi: 10.1016/j.jacep.2024.10.024. Epub 2025 Jan 8.

Abstract

Left atrial appendage occlusion (LAAO) has become an important therapeutic target for stroke prevention in patients with nonvalvular atrial fibrillation. Over the past 2 decades, several advancements in LAAO devices (percutaneous and surgical) have been made for stroke prevention and arrhythmia therapy. However, there are several unanswered questions regarding optimal patient selection, the preferred LAAO approach and device, the management of periprocedural and postprocedural complications, including pericardial effusion, device-related thrombus, and device leaks. This review focuses on fundamental foundational concepts in various aspects of the left atrial appendage and management strategies as they relate to current clinical needs.

摘要

左心耳封堵术(LAAO)已成为非瓣膜性心房颤动患者预防卒中的重要治疗靶点。在过去20年中,LAAO装置(经皮和外科)在预防卒中和心律失常治疗方面取得了多项进展。然而,关于最佳患者选择、首选的LAAO方法和装置、围手术期和术后并发症(包括心包积液、装置相关血栓和装置渗漏)的管理,仍有几个问题尚未得到解答。本综述重点关注左心耳各个方面的基本概念以及与当前临床需求相关的管理策略。

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