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经导管缘对缘修复术与左心耳封堵术同期进行

Concomitant Transcatheter Edge-to-Edge Repair and Left Atrial Appendage Occlusion.

作者信息

Prosperi-Porta Graeme, Dryden Adam, Nicholson Donna, Hynes Mark, Chan Vincent, Jung Richard G, Di Santo Pietro, Simard Trevor, Labinaz Marino, Hibbert Benjamin, Abdel-Razek Omar

机构信息

Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada.

Division of Cardiac Anesthesiology, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada.

出版信息

J Clin Med. 2025 Mar 26;14(7):2257. doi: 10.3390/jcm14072257.

Abstract

: Atrial fibrillation is a frequent comorbidity amongst patients undergoing mitral valve transcatheter edge-to-edge repair (M-TEER) for mitral regurgitation. Left atrial appendage occlusion (LAAO) can be performed to reduce the risk of stroke in patients with atrial fibrillation. Both procedures require large-bore venous access, transseptal puncture, and real-time imaging of the left atrium. However, limited data exist evaluating the safety and feasibility of concomitant M-TEER and LAAO. : We performed a retrospective review of all concomitant M-TEER and LAAO procedures at our institution between May 2019 and September 2024 to evaluate the safety and feasibility of this approach. : Concomitant left atrial appendage occlusion was successful in all 15 patients, requiring an additional 15 min (IQR 11-29) of procedural time. No patients died or had a major vascular complication. Routine transesophageal echocardiography performed within 90 days showed no device related thrombus, and no significant peri-device leak in any patients. : Concomitant M-TEER and LAAO are feasible but additional prospective studies or randomized trials are needed to evaluate the potential clinical benefit.

摘要

心房颤动是接受经导管二尖瓣缘对缘修复术(M-TEER)治疗二尖瓣反流患者中常见的合并症。对于心房颤动患者,可进行左心耳封堵术(LAAO)以降低中风风险。这两种手术都需要大口径静脉通路、经房间隔穿刺以及左心房实时成像。然而,评估同时进行M-TEER和LAAO的安全性和可行性的数据有限。

我们对2019年5月至2024年9月期间在本机构进行的所有同时进行M-TEER和LAAO的手术进行了回顾性分析,以评估这种方法的安全性和可行性。

15例患者同时进行左心耳封堵术均获成功,手术时间额外增加15分钟(四分位间距11 - 29分钟)。无患者死亡或发生重大血管并发症。90天内进行的常规经食管超声心动图检查显示,所有患者均未出现与器械相关的血栓形成,且无明显的器械周围渗漏。

同时进行M-TEER和LAAO是可行的,但需要进一步的前瞻性研究或随机试验来评估其潜在的临床益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f54d/11989949/885a3080fcf6/jcm-14-02257-g001.jpg

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