左心房尾闭塞:日常实践中的皮肤和外科手术方法
Jan Gofus1, Pavel Zacek2, Youssef Shahin2
1Department of Cardiac Surgery, Charles University, Faculty of Medicine and University Hospital in Hradec Kralove, Hradec Kralove, Czech Republic. jan.gofus@gmail.com.
Kardiologia polska
|March 17, 2024
概括
预防性左心房尾闭塞有效降低心房动患者的心脏栓塞风险. 关于不良影响的担忧没有得到当前证据的支持,尽管血液动力学影响需要进一步研究.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 血栓形成的管理
背景情况:
- 心房动 (AF) 具有显著的心血管栓塞事件风险.
- 为了减轻这种风险,正在探索左心房附属体封闭 (LAAO).
- 关于LAAO的临床益处和潜在的不良影响,存在相互矛盾的数据.
研究的目的:
- 在AF患者中全面审查关于预防性LAAO的文献.
- 评估LAAO在减少血栓栓塞的有效性和安全性.
- 为LAAO决策提供临床建议.
主要方法:
- 使用Medline通过PubMed进行了系统的文献搜索.
- 根据标题和摘要评论,选出了65篇相关文章.
- 审查的重点是血栓栓塞瘤风险降低,安全性和不良影响.
主要成果:
- 在心脏手术期间同时服用LAAO在高CHA2DS2-VASc分数的AF患者中有效降低血栓栓塞的风险.
- 手术上心膜关闭是一种安全和首选的技术;胸腔镜和透导管方法也可行.
- 证据不支持对内分泌失衡或闭塞后心力衰竭的担忧.
结论:
- 在某些AF患者中,LAAO是一种有效的策略,可降低血栓栓塞的风险.
- 手术LAAO是安全的,有各种技术可用于个性化治疗.
- 目前的证据驳斥了内分泌或心力衰竭的担忧,但血液动力学效应需要进一步调查.
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