使用专用取出系统经皮取出左心耳封堵装置
Percutaneous Removal of Left Atrial Appendage Occlusion Device With a Dedicated Retrieval System.
作者信息
Guddeti Raviteja R, Sayed Amer, Seshiah Puvi, Bae Richard, Garcia Santiago
机构信息
Carl and Edyth Lindner Research Center at the Christ Hospital, Cincinnati, Ohio, USA.
Premier Health, Dayton, Ohio, USA.
出版信息
JACC Case Rep. 2025 Aug 20;30(24):104751. doi: 10.1016/j.jaccas.2025.104751.
OBJECTIVE
Successful use of a novel percutaneous retrieval system (ŌNŌ retrieval system, ŌNŌCOR) to remove a significantly dislodged left atrial appendage occlusion device (Watchman FLX, Boston Scientific).
KEY STEPS
First, a 17-F Bayliss VersaConnect and TruSteer catheter was advanced through a 20-F DrySeal sheath (Gore Medical). Then, the ŌNŌ retrieval system was advanced and positioned against the Watchman FLX device. Through this system, a 2.4-mm Raptor forceps (Steris) was advanced to grab one of the struts on the Watchman device. Slow traction on the Raptor forceps and simultaneous advancement of the ŌNŌ basket was performed to dislodge the Watchman device from the left atrial appendage.
POTENTIAL PITFALLS
Device embolization, left atrial appendage avulsion, and pericardial effusion are some of the potential complications of the Watchman retrieval procedure.
TAKE-HOME MESSAGE: Embolization of a left atrial appendage occlusion device is a rare but potentially devastating complication, and percutaneous retrieval with the ŌNŌ system may provide a safer alternative to surgical removal.
目的
成功使用一种新型经皮取出系统（大野取出系统，ŌNŌCOR）移除严重移位的左心耳封堵装置（Watchman FLX，波士顿科学公司）。
关键步骤
首先，将一根17F的贝利斯VersaConnect和TruSteer导管通过一根20F的DrySeal鞘管（戈尔医疗公司）推进。然后，推进大野取出系统并使其靠在Watchman FLX装置上。通过该系统，推进一根2.4毫米的猛禽钳（史赛利思公司）以抓住Watchman装置上的一个支柱。缓慢拉动猛禽钳并同时推进大野篮筐，以使Watchman装置从左心耳中脱出。
潜在陷阱
装置栓塞、左心耳撕裂和心包积液是Watchman取出手术的一些潜在并发症。
经验教训
左心耳封堵装置的栓塞是一种罕见但可能具有毁灭性的并发症，使用大野系统进行经皮取出可能为手术移除提供一种更安全的替代方法。
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