免疫抑制药物对皮肤穿透左耳附带塞住患者的影响
Daisuke Togashi1, Christopher R Ellis1, Zachary T Yoneda1
1Cardiovascular Division, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Journal of cardiovascular electrophysiology
|August 29, 2025
概括
在接受免疫抑制疗法 (IMS) 的患者中,穿皮左心房附带关闭 (LAAC) 是安全的. 虽然术后结果相似,但这些患者在随访期间面临更高的全身感染率和较低的器械外泄改善.
科学领域:
- 心脏病学
- 干预心脏病学
- 医疗器械
背景情况:
- 在无法使用口服抗凝药的非膜性心房动患者中,穿皮左心房关闭 (LAAC) 是一种降低中风风险的策略.
- 在慢性免疫抑制治疗 (IMS) 的患者中,LAAC的结果尚未确立.
研究的目的:
- 评估长期接受IMS治疗的患者皮肤穿透的LAAC的安全性和有效性.
- 为了比较IMS和非IMS患者的术后和长期结果.
主要方法:
- 在2017年11月至2023年3月接受LAAC的1172名患者的回顾性评估.
- 根据长期免疫抑制疗法 (IMS) 的使用情况对患者进行分类.
- 分析包括外科手术后的并发症,临床结果和设备后续特征,包括外科设备泄漏 (PDL) 和设备相关的血栓.
主要成果:
- 在IMS和非IMS组之间,手术后并发症没有显著差异 (1.4%对1.3%).
- 在平均617天的随访期间,IMS组的系统性感染发病率较高 (25. 0%对6. 1%).
- 在周围设备泄漏 (PDL) 或与设备相关的血栓没有显著差异,但在IMS组中PDL的改善较低 (8. 3%与50. 0%相比).
结论:
- 通过皮肤的LAAC可以在慢性IMS患者中成功进行,而不会增加外科手术后的风险.
- 长期随访显示,在LAAC治疗后,IMS患者的全身感染风险增加.
- 随着时间的推移,IMS使用与周围设备泄漏的改善有关.
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