在左心房附属器关闭后,延迟周周器泄漏的发生率和时间演变
Sapan Bhuta1, Austin Carlen1, Salvatore J Savona1
1Electrophysiology Section, Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio.
Heart rhythm
|May 26, 2024
概括
用Watchman FLX关闭左心房附属体 (LAAC) 后的周周器件泄漏 (PDL) 在39%的患者中发生,通常自发地消失. 虽然PDL与不良结果有关,但大多数泄漏会随着时间的推移出现回归.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 干预程序 干预程序
背景情况:
- 在左心房附属体关闭 (LAAC) 后的周周器件泄漏 (PDL) 与不良的临床结果有关.
- 了解PDL对于改善LAAC后的患者管理至关重要.
研究的目的:
- 使用Watchman FLX设备确定LAAC后PDL的发病率,预测因素,临床影响和时间变化.
- 分析PDL的长期后果和自然史.
主要方法:
- 用Watchman FLX进行LAAC的患者的回顾性分析,不包括在植入时患有PDL的患者.
- 主要终点:在初始成像时出现新的PDL的发生率.
- 二级终点:持续抗凝药,与设备相关的血栓,血栓栓塞事件,出血和需要PDL关闭的组合.
主要成果:
- 在355名患者中有39%的患者观察到新的PDL (平均泄漏大小为3.2毫米).
- 对于PDL的积极预测因素包括多次部署尝试和更大的设备大小;增加的对比度量是负面预测因素.
- 复合二次终点发生在30%的PDL患者中,而没有PDL的患者为15% (P < .001).
- 在患有PDL的患者中,泄漏尺寸从46天的3.7毫米显著回归到189天的1.7毫米 (P < .001).
结论:
- 观察者FLX设备显示了PDL的显著发病率与临床影响,尽管设计改进.
- 大多数PDL随着时间的推移表现出自发的回归,无论它们的初始大小如何.
- 在LAAC后的环境中,PDL仍然是一个重要的考虑因素,需要持续监测和管理策略.
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