在边界尺寸解剖学中,左心室尾关闭后,设备尺寸对结果的影响
Kensuke Kuwabara1, Shunsuke Kubo2, Yoshifumi Nakajima3
1Department of Cardiology, Kishiwada Tokushukai Hospital, Kishiwada, Japan.
JACC. Asia
|January 22, 2026
概括
对于边界左心房附属体 (LAA) 关闭,使用更大的WATCHMAN FLX设备可以减少周围设备泄漏和缺血事件. 这种方法提供了改善的结果,而不会增加非膜性心房动患者的程序风险.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 干预心脏病学 干预心脏病学
背景情况:
- 为边界左心房附属体 (LAA) 选择最佳的WATCHMAN FLX设备尺寸是一项挑战.
- 对于这些边界病例来说,两种设备大小通常是可以接受的,这使得决策过程变得复杂.
研究的目的:
- 评估设备尺寸对接受边界尺寸LAA关闭LAA的患者的程序和临床结果的影响.
- 为了在这个特定的患者群体中比较更大和更小的设备尺寸之间的结果.
主要方法:
- 在日本多中心TERMINATOR注册表中的757名患者进行了回顾性审查,这些患者使用第二代WATCHMAN FLX设备进行了LAA关闭.
- 具有边界大小LAA的患者被分为大 (n=390) 和小 (n=367) 设备组.
- 评估的结果包括周围设备泄漏 (PDL),死亡率,脑血管事件,出血和与设备相关的血栓,平均随访时间为274天.
主要成果:
- 大型设备组的周周设备泄漏率显著降低 (1.54%对4.90%;P=0.015) 和缺血性脑血管事故或全身栓塞 (8.4%对10.5%;P=0.036).
- 两组之间在全因死亡率,重大出血或与设备相关的血栓方面没有发现显著差异.
- 在这个队列中,更大的器械尺寸表明了有利的安全性和有效性概况.
结论:
- 在边界大小的LAA中,使用更大的WATCHMAN FLX设备与减少周围设备泄漏和缺血事件有关.
- 在这些情况下使用更大的设备似乎不会增加程序风险.
- 这些发现支持在边界LAA解剖学中考虑更大的设备尺寸以获得最佳结果.
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