PDF(Pubmed)
Abstract：
UNASSIGNED: Left atrial appendage (LAA) thrombus is a contraindication for LAA closure (LAAC). However, in selected cases, oral anticoagulants are strictly contraindicated because of a history of life-threatening bleeding, and LAAC remains the only possible therapy to avoid systemic and especially cerebral embolization.
UNASSIGNED: We report a case of LAAC despite a massive proximal thrombus in a patient who had an absolute contraindication to anticoagulant therapy, with thorough pre-planning using CT scan, device modelling and thrombus trapping techniques to reduce the risk of systemic embolic events and perform LAAC safely.
UNASSIGNED: Although LAAC remains at high risk in this setting, the use of cautious techniques and tools, from pre-procedure planning to systemic embolization prevention systems associated to a precise transoesopheageal echocardiography guiding throughout the procedure, allows it to be performed as safely as possible when no other option is available.
UNASSIGNED: We report a case of LAAC despite a massive proximal thrombus in a patient who had an absolute contraindication to anticoagulant therapy, with thorough pre-planning using CT scan, device modelling and thrombus trapping techniques to reduce the risk of systemic embolic events and perform LAAC safely.
UNASSIGNED: Although LAAC remains at high risk in this setting, the use of cautious techniques and tools, from pre-procedure planning to systemic embolization prevention systems associated to a precise transoesopheageal echocardiography guiding throughout the procedure, allows it to be performed as safely as possible when no other option is available.
摘要：
■左心耳(LAA)血栓是左心耳封堵(LAAC)的禁忌症。然而,在选定的情况下，口服抗凝剂是严格禁忌的，因为有危及生命的出血史，和LAAC仍然是唯一可能的治疗，以避免全身性，尤其是脑栓塞。
■我们报告了一例LAAC病例，尽管有抗凝治疗绝对禁忌症的患者存在大量近端血栓，使用CT扫描进行全面的预先计划，设备建模和血栓捕获技术，以降低全身栓塞事件的风险并安全执行LAAC。
■尽管LAAC在这种情况下仍然处于高风险状态，使用谨慎的技术和工具，从术前计划到全身栓塞预防系统，这些系统与整个手术过程中精确的经食管超声心动图指导相关，允许在没有其他选项可用时尽可能安全地执行。
■我们报告了一例LAAC病例，尽管有抗凝治疗绝对禁忌症的患者存在大量近端血栓，使用CT扫描进行全面的预先计划，设备建模和血栓捕获技术，以降低全身栓塞事件的风险并安全执行LAAC。
■尽管LAAC在这种情况下仍然处于高风险状态，使用谨慎的技术和工具，从术前计划到全身栓塞预防系统，这些系统与整个手术过程中精确的经食管超声心动图指导相关，允许在没有其他选项可用时尽可能安全地执行。
