零对比性皮肤穿透左前庭尾关闭:一个大规模的,单中心的,现实世界的研究
Ahmet Hakan Ateş1, Mert Doğan1, Ahmet Kıvrak1
1Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Pacing and clinical electrophysiology : PACE
|January 19, 2026
概括
使用TEE和光镜进行的零对比的左心房尾关闭 (LAAC) 是非膜心房动 (AF) 患者中风预防的安全和有效方法. 这种技术为患有功能障碍的人提供了优势,降低了急性损伤风险.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學.
- 医疗器械 医疗器械
背景情况:
- 左心房尾关闭 (LAAC) 是针对不膜心房动 (AF) 患者的中风预防策略,不适合抗凝药.
- 在LAAC中使用的类对比剂存在急性损伤 (AKI) 的风险,特别是在慢性病 (CKD) 患者中.
- 评估可替代的LAAC技术,以尽量减少对比度暴露,对于患者安全至关重要.
研究的目的:
- 评估零对比度LAAC程序的安全性和有效性.
- 在零对比度LAAC中确定重大并发症的发生率和程序成功率.
- 评估零对比的LAAC对患有和没有CKD的患者功能的影响.
主要方法:
- 在2014年1月至2025年1月期间,对324名连续接受零对比LAAC的患者进行了回顾性研究.
- 手术的指导是经食道心声学 (TEE) 和光镜,没有含的对比剂.
- 主要安全终点是7天内出现重大并发症的复合;次要终点是程序成功.
主要成果:
- 该手术的成功率很高 (99.7%),严重并发症率很低 (2.46%).
- 在指数住院期间没有观察到急性损伤 (AKI) 的病例,并且在患有先前存在的CKD的患者中,功能保持稳定.
- 在患有进展性功能障碍的患者中,存活率明显较低.
结论:
- 由TEE和光学指导的零对比度LAAC是对比度增强LAAC的安全有效替代品.
- 这种技术对患有功能障碍的患者特别有益,可减轻AKI风险.
- 这些发现支持在高风险人群中更广泛地采用对比避开策略.
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