PDF(Pubmed)
Abstract：
UNASSIGNED: Percutaneous interventional left atrial appendage occlusion (LAAO) is a reliable, safe, and effective alternative for stroke prevention in selected patients with atrial fibrillation (AF).
UNASSIGNED: In a retrospective observational study, 149 patients underwent LAAO between 2016 and 2022 at the Department of Cardiology of the Charité-Universitätsmedizin Berlin, Campus Virchow, with AF for prevention of thromboembolic complications. We compared patient characteristics, intraoperative details and postoperative outcomes between single-occlusive plug-type (SOPT) and dual-occlusive disc-type (DODT) devices.
UNASSIGNED: In all patients, the device implantation was successful. 60 patients received a SOPT occluder, including Watchman (35%) and Watchman FLX Occluders (65%), while 89 patients received a DODT occluder, including Amplatzer Cardiac Plug (37.1%), the Amplatzer Amulet (25.8%), and the LAmbre occluder (37.1%) systems. Procedure duration was significantly longer for DODT occluder implantation (49 ± 33 vs. 41 ± 25 min, p = 0.018). There were no in-hospital deaths or thromboembolic events reported after LAAO in both groups. Beyond that, a low rate of bleeding or access-side-related complications and pericardial tamponades were observed. Anticoagulation at discharge varied. About 60.8% of patients received dual antiplatelet therapy at hospital discharge, and 33.1% received direct oral anticoagulants. A 6-month follow-up was obtained in 85% of the patients. All implanted devices were in the desired position. However, in 5.7% of the patients, a device-related thrombus formation was detected in the SOPT group, while no thrombus was seen in the DODT group (p = 0.11). Thromboembolic events were noticed in 3.1%, without any difference between the device types. There was a statistically non-significant trend for less residual device leaks after SOPT vs. DODT implantation (no leak in 71.7% vs. 62.2%, p = 0.07; minor leaks <5 mm, 9.4% vs. 20.3%, p = 0.1). In the SOPT group, less bleeding complications were reported after LAAO (11.3% vs. 17.6%, p = 0.1).
UNASSIGNED: Our data suggest the safety and efficiency of LAAO with a very high procedural implantation success rate irrespective of the used LAA device. Furthermore, no relevant procedural or device-related complication occurred during the 6-month follow-up in all patients.
UNASSIGNED: In a retrospective observational study, 149 patients underwent LAAO between 2016 and 2022 at the Department of Cardiology of the Charité-Universitätsmedizin Berlin, Campus Virchow, with AF for prevention of thromboembolic complications. We compared patient characteristics, intraoperative details and postoperative outcomes between single-occlusive plug-type (SOPT) and dual-occlusive disc-type (DODT) devices.
UNASSIGNED: In all patients, the device implantation was successful. 60 patients received a SOPT occluder, including Watchman (35%) and Watchman FLX Occluders (65%), while 89 patients received a DODT occluder, including Amplatzer Cardiac Plug (37.1%), the Amplatzer Amulet (25.8%), and the LAmbre occluder (37.1%) systems. Procedure duration was significantly longer for DODT occluder implantation (49 ± 33 vs. 41 ± 25 min, p = 0.018). There were no in-hospital deaths or thromboembolic events reported after LAAO in both groups. Beyond that, a low rate of bleeding or access-side-related complications and pericardial tamponades were observed. Anticoagulation at discharge varied. About 60.8% of patients received dual antiplatelet therapy at hospital discharge, and 33.1% received direct oral anticoagulants. A 6-month follow-up was obtained in 85% of the patients. All implanted devices were in the desired position. However, in 5.7% of the patients, a device-related thrombus formation was detected in the SOPT group, while no thrombus was seen in the DODT group (p = 0.11). Thromboembolic events were noticed in 3.1%, without any difference between the device types. There was a statistically non-significant trend for less residual device leaks after SOPT vs. DODT implantation (no leak in 71.7% vs. 62.2%, p = 0.07; minor leaks <5 mm, 9.4% vs. 20.3%, p = 0.1). In the SOPT group, less bleeding complications were reported after LAAO (11.3% vs. 17.6%, p = 0.1).
UNASSIGNED: Our data suggest the safety and efficiency of LAAO with a very high procedural implantation success rate irrespective of the used LAA device. Furthermore, no relevant procedural or device-related complication occurred during the 6-month follow-up in all patients.
摘要：
■经皮介入左心耳封堵术（LAAO）是一种可靠的，安全,以及在选定的房颤（AF）患者中预防中风的有效替代方法。
■在一项回顾性观察研究中，2016年至2022年期间，149名患者在柏林Charité-Universityätsmedizin心脏病学系接受LAAO治疗，校园Virchow，房颤用于预防血栓栓塞并发症。我们比较了患者特征，单闭塞塞式（SOPT）和双闭塞盘式（DODT）装置之间的术中细节和术后结局。
■在所有患者中，装置植入成功.60名患者接受了SOPT封堵器，包括《守望者》(35%)和《守望者》(65%),89名患者接受了DODT封堵器，包括Amplatzer(37.1%),Amplatzer护身符（25.8%），和LAmbre封堵器（37.1％）系统。DODT封堵器植入的手术持续时间明显更长（49±33vs.41±25分钟,p=0.018)。两组患者在LAAO治疗后均未发生院内死亡或血栓栓塞事件。除此之外，观察到出血或入路相关并发症和心包填塞的发生率较低.出院时的抗凝作用各不相同。约60.8%的患者在出院时接受双重抗血小板治疗,33.1%接受了直接口服抗凝剂.85%的患者获得了6个月的随访。所有植入的装置都处于所需位置。然而,在5.7%的患者中，在SOPT组中检测到与装置相关的血栓形成,而DODT组未见血栓（p=0.11）。血栓栓塞事件发生率为3.1%,设备类型之间没有任何区别。SOPT与SOPT后残留设备泄漏较少，在统计学上趋势不显着。DODT植入(71.7%与62.2%,p=0.07；轻微泄漏<5mm，9.4%与20.3%,p=0.1)。在SOPT组中，LAAO术后出血并发症较少(11.3%vs.17.6%,p=0.1)。
■我们的数据表明，无论使用何种左心耳装置，LAAO的安全性和有效性均具有非常高的手术成功率。此外，在6个月随访期间,所有患者均未发生相关手术或器械相关并发症.
■在一项回顾性观察研究中，2016年至2022年期间，149名患者在柏林Charité-Universityätsmedizin心脏病学系接受LAAO治疗，校园Virchow，房颤用于预防血栓栓塞并发症。我们比较了患者特征，单闭塞塞式（SOPT）和双闭塞盘式（DODT）装置之间的术中细节和术后结局。
■在所有患者中，装置植入成功.60名患者接受了SOPT封堵器，包括《守望者》(35%)和《守望者》(65%),89名患者接受了DODT封堵器，包括Amplatzer(37.1%),Amplatzer护身符（25.8%），和LAmbre封堵器（37.1％）系统。DODT封堵器植入的手术持续时间明显更长（49±33vs.41±25分钟,p=0.018)。两组患者在LAAO治疗后均未发生院内死亡或血栓栓塞事件。除此之外，观察到出血或入路相关并发症和心包填塞的发生率较低.出院时的抗凝作用各不相同。约60.8%的患者在出院时接受双重抗血小板治疗,33.1%接受了直接口服抗凝剂.85%的患者获得了6个月的随访。所有植入的装置都处于所需位置。然而,在5.7%的患者中，在SOPT组中检测到与装置相关的血栓形成,而DODT组未见血栓（p=0.11）。血栓栓塞事件发生率为3.1%,设备类型之间没有任何区别。SOPT与SOPT后残留设备泄漏较少，在统计学上趋势不显着。DODT植入(71.7%与62.2%,p=0.07；轻微泄漏<5mm，9.4%与20.3%,p=0.1)。在SOPT组中，LAAO术后出血并发症较少(11.3%vs.17.6%,p=0.1)。
■我们的数据表明，无论使用何种左心耳装置，LAAO的安全性和有效性均具有非常高的手术成功率。此外，在6个月随访期间,所有患者均未发生相关手术或器械相关并发症.
