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左心耳封堵术后器械栓塞的处理:两例病例及文献综述

Management of device embolization following left atrial appendage closure: Two cases and a review of the literature.

作者信息

Kivrak Ahmet, Ates Ahmet Hakan, Canpolat Ugur, Dogan Mert, Coteli Cem, Yorgun Hikmet, Sahiner Mehmet Levent, Kaya Ergun Barıs, Aytemir Kudret

机构信息

Department of Cardiology Hacettepe University Faculty of Medicine Ankara Turkey.

出版信息

J Arrhythm. 2025 Aug 1;41(4):e70139. doi: 10.1002/joa3.70139. eCollection 2025 Aug.

Abstract

OBJECTIVES

Device embolization (DE) following left atrial appendage closure (LAAC) is a severe but uncommon complication, and limited data address optimal management strategies for this condition. This review presents two cases of device embolization (DE) following LAAC and discusses risk factors, incidence, and management strategies through a literature-based approach.

METHODS

A comprehensive literature review was conducted, including studies focused on DE after LAAC, examining percutaneous and surgical retrieval techniques, procedural success, and patient outcomes.

RESULTS AND CONCLUSION

DE incidence ranges from 0.6% to 1.5%, with improper device sizing and anatomical factors as primary risk factors. Percutaneous retrieval, through transseptal or transarterial approaches, demonstrates high procedural success rates, while surgical retrieval remains an option for complex cases. Our review suggests that with experienced operators, tailored percutaneous strategies effectively manage DE following LAAC.

摘要

目的

左心耳封堵术(LAAC)后装置栓塞(DE)是一种严重但不常见的并发症,针对这种情况的最佳管理策略的数据有限。本综述介绍了两例LAAC后装置栓塞(DE)的病例,并通过基于文献的方法讨论了危险因素、发生率和管理策略。

方法

进行了全面的文献综述,包括专注于LAAC后DE的研究,考察经皮和手术取出技术、手术成功率和患者预后。

结果与结论

DE的发生率在0.6%至1.5%之间,装置尺寸不当和解剖因素是主要危险因素。经房间隔或经动脉途径的经皮取出显示出较高的手术成功率,而手术取出仍是复杂病例的一种选择。我们的综述表明,在经验丰富的操作者手中,量身定制的经皮策略可有效处理LAAC后的DE。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35d2/12314921/9ae3c00151ea/JOA3-41-e70139-g003.jpg

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