左心室尾关闭后的心周溢血:时间,预测因素和临床影响
Roberto Galea1, Tommaso Bini1, Juan Perich Krsnik1
1Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland.
JACC. Cardiovascular interventions
|May 25, 2024
概括
在左心房附属体关闭 (LAAC) 后心周溢血 (PE) 发生在不到5%的患者中,通常在6小时内发生. 双关装置,女性性别,基线口服抗凝药和年龄较大预测PE风险.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 心周溢血 (PE) 是左心房附属物关闭 (LAAC) 的一个显著并发症.
- 了解LAAC后PE的机制,时间和影响对于患者的安全至关重要.
- 目前关于LAAC后PE的知识有限.
研究的目的:
- 为了确定PE的发病率,时间和预测因素,按照LAAC.
- 评估LAAC后PE的临床意义和预后影响.
- 为了确定与PE发展相关的患者和程序因素.
主要方法:
- 从LAAC程序 (2009-2022) 收集未来的数据,并对其进行一年的后续调查.
- 包括单个和双个LAAC设备类型 (例如,守望者,安普拉特,护身符).
- 影像核心实验室对PE的判断,分为早期 (≤7天) 或晚期 (8-365天);用于预测分析的后勤回归.
主要成果:
- 在1023个LAAC手术中,PE发生在4.3%的手术中,其中3.3%是早期的,0.9%是晚期的.
- 大多数PE (56.8%) 发生在手术后6小时内;63.6%具有临床意义.
- 早期PE的独立预测因素包括双关装置 (OR:8.20),女性性别 (OR:3.41),基线口服抗凝剂 (OR:2.60) 和晚年 (OR:1.07).
结论:
- 心周溢血是LAAC罕见但显著的并发症,通常发生在早期.
- 双关装置,女性性别,基线口服抗凝药和晚年是PE的关键预测因素.
- 早期发现和管理PE对于改善LAAC后的结果至关重要.
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