在使用Watchman装置关闭左心房附属体后,与设备相关的血栓的发生率和预测因素
Jakub Maksym1, Piotr Scisło1, Agnieszka Kapłon-Cieślicka1
1First Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
概括
在左心房附带关闭 (LAAC) 后的设备相关血栓 (DRT) 是罕见的,但与患者因素有关. 较低的射出分数,较低的LAA排空速度和更深的植入预测心房患者的DRT.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 血栓形成的原因之一是血栓形成.
背景情况:
- 使用Watchman设备关闭左心房尾 (LAAC) 是一种预防心房动 (AF) 患者血栓栓塞的策略.
- 一个潜在的并发症是植入装置的心房表面上发生与装置相关的血栓 (DRT).
研究的目的:
- 为了确定与设备相关的血栓 (DRT) 的发生率,这些患者使用Watchman设备接受了LAAC.
- 确定与DRT形成相关的患者和程序预测因素.
主要方法:
- 78名AF患者的回顾性分析,这些患者使用第一代Watchman 2.5设备进行了LAAC.
- 患者在手术后接受了抗血小板治疗.
- 经食道心声学 (TEE) 用于临床随访,以评估DRT.
主要成果:
- 与设备相关的血栓 (DRT) 在6.4%的患者中被观察到.
- 预测DRT的预测因素包括较低的射出分数,较低的左心房附属体 (LAA) 排空速度,更大的植入深度,更大的LAA尺寸和更年轻的患者年龄.
- 接受DRT的患者具有显著较低的射出分数 (p=0.005),较低的LAA排空速度 (p=0.009),以及更大的植入深度 (p<0.001).
结论:
- 对LAAC的Watchman设备植入后的设备相关血栓 (DRT) 是一个不常见的并发症.
- 特定的患者特征和程序因素似乎与DRT发展有关.
- 需要在更大的队列中进行进一步的调查,以确认这些发现并完善风险分层.
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