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