Abstract：
BACKGROUND: Limited data exists regarding incidence, progression, and predictors of left atrial appendage (LAA) sealing after transcatheter LAA closure. We aimed to evaluate the incidence, progression, and predictive factors associated with LAA sealing after LAA closure.
METHODS: This study includes patients who underwent successful LAA closure with Watchman FLX device and had both pre- and postprocedural computed tomography (CT). Postprocedural CT was performed 45 days after LAA closure and used to evaluate residual LAA patency. Patient who had residual LAA patency at 45 days underwent 1-year follow-up CT.
RESULTS: A total of 105 patients (mean age: 75.2 ± 9.6 years; 53.3% female) who underwent successful LAA closure with Watchman FLX device and had pre- and postprocedural CT at 45 days were included. Residual patency was observed in 35 (33.3%) patients: 21 (20.0%) patients showed complete contrast opacification in LAA (complete LAA patency) while 14 (13.3%) patients showed contrast opacification only in the distal LAA (distal LAA patency). Among patients with residual LAA patency at 45 days, the rate of LAA sealing at 1 year was significantly higher in the distal LAA patency group than in the complete LAA patency group (75.0% vs. 16.7%; p = 0.019). Increased depth oversizing was associated with both distal LAA patency and complete LAA patency.
CONCLUSIONS: Postprocedural CT at 45 days detected patent LAA in one-third of patients after LAA closure. LAA sealing was more frequently observed at 1 year among the distal LAA patency group than the complete LAA patency group.
METHODS: This study includes patients who underwent successful LAA closure with Watchman FLX device and had both pre- and postprocedural computed tomography (CT). Postprocedural CT was performed 45 days after LAA closure and used to evaluate residual LAA patency. Patient who had residual LAA patency at 45 days underwent 1-year follow-up CT.
RESULTS: A total of 105 patients (mean age: 75.2 ± 9.6 years; 53.3% female) who underwent successful LAA closure with Watchman FLX device and had pre- and postprocedural CT at 45 days were included. Residual patency was observed in 35 (33.3%) patients: 21 (20.0%) patients showed complete contrast opacification in LAA (complete LAA patency) while 14 (13.3%) patients showed contrast opacification only in the distal LAA (distal LAA patency). Among patients with residual LAA patency at 45 days, the rate of LAA sealing at 1 year was significantly higher in the distal LAA patency group than in the complete LAA patency group (75.0% vs. 16.7%; p = 0.019). Increased depth oversizing was associated with both distal LAA patency and complete LAA patency.
CONCLUSIONS: Postprocedural CT at 45 days detected patent LAA in one-third of patients after LAA closure. LAA sealing was more frequently observed at 1 year among the distal LAA patency group than the complete LAA patency group.
摘要：
背景：关于发病率的数据有限，programming,以及经导管左心耳(LAA)封堵术后左心耳封堵的预测因素。我们的目的是评估发病率，programming,LAA封堵后与LAA封堵相关的预测因素。
方法：本研究包括使用WatchmanFLX装置成功进行左心耳封堵并同时进行术前和术后计算机断层扫描（CT）的患者。LAA闭合后45天进行术后CT检查，用于评估残余LAA通畅性。在45天有残余LAA通畅的患者接受1年随访CT。
结果：共纳入105例患者（平均年龄：75.2±9.6岁；53.3%为女性），这些患者使用WatchmanFLX装置成功进行了左心耳封堵，并在45天进行了术前和术后CT检查。在35例（33.3％）患者中观察到残余通畅：21例（20.0％）患者在LAA中显示完全造影剂混浊（完全LAA通畅），而14例（13.3％）患者仅在远端LAA中显示造影剂混浊（远端LAA通畅）。在45天有残留左心耳通畅的患者中，远端LAA通畅组1年LAA封堵率明显高于完全LAA通畅组(75.0%vs.16.7%；p=0.019）。深度增大与远端左心耳通畅和完全左心耳通畅有关。
结论：术后CT在45天时在1/3的患者LAA封堵后发现LAA专利。远端LAA通畅组比完全LAA通畅组在1年时更频繁地观察到LAA密封。
方法：本研究包括使用WatchmanFLX装置成功进行左心耳封堵并同时进行术前和术后计算机断层扫描（CT）的患者。LAA闭合后45天进行术后CT检查，用于评估残余LAA通畅性。在45天有残余LAA通畅的患者接受1年随访CT。
结果：共纳入105例患者（平均年龄：75.2±9.6岁；53.3%为女性），这些患者使用WatchmanFLX装置成功进行了左心耳封堵，并在45天进行了术前和术后CT检查。在35例（33.3％）患者中观察到残余通畅：21例（20.0％）患者在LAA中显示完全造影剂混浊（完全LAA通畅），而14例（13.3％）患者仅在远端LAA中显示造影剂混浊（远端LAA通畅）。在45天有残留左心耳通畅的患者中，远端LAA通畅组1年LAA封堵率明显高于完全LAA通畅组(75.0%vs.16.7%；p=0.019）。深度增大与远端左心耳通畅和完全左心耳通畅有关。
结论：术后CT在45天时在1/3的患者LAA封堵后发现LAA专利。远端LAA通畅组比完全LAA通畅组在1年时更频繁地观察到LAA密封。
