一种新的方法,使用身体表面钢球作为参考尺度来测量左心房附属体,以优化Watchman设备的选择
He Jin1, Mingjun Feng1, Xianfeng Du1
1Cardiac Arrhythmia Center, The First Affiliated Hospital of Ningbo University, Ningbo, China.
Frontiers in cardiovascular medicine
|March 31, 2025
概括
新型钢球法准确地测量左心房附属体 (LAA) 对于心房患者的Watchman设备选择. 这种安全有效的技术可以改善LAAC手术的结果,而不是传统的外套方法.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 医疗器械技术 医疗器械技术
背景情况:
- 左心房尾关闭 (LAAC) 为预防非膜心房动 (AF) 的中风提供了口服抗凝药的替代方案.
- 对于成功的LAAC程序来说,Watchman设备的精确尺寸是至关重要的.
- 测量左心房附属体 (LAA) 的现有方法存在局限性.
研究的目的:
- 为了评估一种新的"钢球方法"的有效性和安全性,用于在LAAC期间使用Watchman设备测量LAA.
- 为了比较新型钢球方法与传统的"外套方法"和跨食道心声扫描 (TEE) 进行LAA大小测量.
主要方法:
- 在2018年1月至2021年12月期间接受Watchman LAAC的169名AF患者的回顾性分析.
- 一个10毫米的钢球被用作LAA ostium直径和光镜下深度测量的外部参考.
- 观察者设备的选择是基于使用钢球方法获得的测量结果;程序成功和并发症被评估.
主要成果:
- 采用钢球方法,LAA ostium直径的测量结果与TEE (24.73 ± 3.39毫米对比24.39 ± 4.13毫米,p=0.176) 相当.
- 使用钢球法进行的测量结果显示,与基于的方法相比,与真实长度的偏差明显较小 (0.29 ± 0.61毫米,相比之下是4.22 ± 1.42毫米和2.17 ± 1.90毫米,p<0.001).
- 在98.8%的患者中,成功实现了Watchman植入,周围设备泄漏率低 (PDL) 和并发症最小 (1.2%的心周栓塞).
结论:
- 新型钢球方法对于测量LAA和指导LAAC程序中的Watchman设备选择是准确,有效和安全的.
- 仅仅依赖"外方法"可能会导致Watchman设备的尺寸不足,可能会损害程序结果.
- 钢球方法为优化设备选择和提高LAAC的成功率提供了可靠的替代方案.
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