在 Amulet 和 Watchman FLX 之间进行选择的定量考虑以及与设备相关的并发症的管理
Alexander Kushnir1, Chirag R Barbhaiya2, Lior Jankelson2
1Leon H. Charney Division of Cardiology, Cardiac Electrophysiology, NYU Langone Health, New York University Grossman School of Medicine, 424 East 34th Street, KP 4th Floor, New York, NY, 10016, USA. Alexander.kushnir@nyulangone.org.
概括
观察者FLX推给左心房附属体解剖学有利的患者,以减少心周溢出,尽管它可能会增加周周器件泄漏. 联合手术可以减少并发症.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗器械 医疗器械
背景情况:
- 包括Amulet和Watchman FLX在内的左心房尾阻塞 (LAA-O) 设备已获得FDA批准,用于降低心房患者中风风险.
- 关于临床结果和成像的真实数据对于设备选择和并发症管理至关重要.
研究的目的:
- 为了比较Amulet和Watchman FLX的临床结果和成像研究结果,左心房尾闭塞装置.
- 评估患者解剖学和联合手术对设备有效性和安全性的影响.
主要方法:
- 临床,食管横断心声学 (TEE) 和计算机断层扫描 (CT) 数据的回顾性分析.
- 在4年的时间里,包括了364个Watchman FLX和292个 Amulet程序.
- 评估手术成功,植入成功,心周溢出,与设备相关的血栓和周围设备泄漏 (PDL).
主要成果:
- FLX (96.7%) 和 Amulet (97.3%) 的程序成功率都很高.
- FLX显示晚期心周溢出率较低 (0.3%对Amulet为3.1%),但临床相关PDL的比率较高 (16%对Amulet为10%).
- 结合AF切除和LAA-O手术表明,PDL和晚期心周输液减少.
结论:
- 对于具有有利的LAA解剖的患者来说,Watchman FLX可能是首选的,以最大限度地减少心周溢出,接受更高的PDL风险.
- 护身符可能是一个合适的替代品,特别是当PDL是主要关注的问题时.
- 结合AF切除和LAA-O程序提供了改善的PDL和输液的结果.
相关概念视频
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Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the...
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01:30Equipments Used To Measure Blood Pressure
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Direct Method
This invasive approach involves cannulating a peripheral artery. During each cardiac contraction, pressure generates mechanical motion within the catheter, transmitted through rigid, fluid-filled tubing to a transducer. This transducer converts mechanical motion into electrical signals displayed as waveforms on a monitor. An automatic flushing system prevents blood backflow. Due to the potential risk of unexpected arterial blood loss, this method is primarily used in intensive...
This invasive approach involves cannulating a peripheral artery. During each cardiac contraction, pressure generates mechanical motion within the catheter, transmitted through rigid, fluid-filled tubing to a transducer. This transducer converts mechanical motion into electrical signals displayed as waveforms on a monitor. An automatic flushing system prevents blood backflow. Due to the potential risk of unexpected arterial blood loss, this method is primarily used in intensive...
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01:25Errors occurring during blood pressure monitoring
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Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...
Several factors...
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01:30Pulse rhythm
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Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
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01:26Flail Chest-II
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Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
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History:
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History:
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01:28Special considerations while measuring blood pressure
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Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
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