经食管超声心动图在经皮WATCHMAN 左心耳封堵术中的应用体会

目的 通过对经食管超声心动图（transesophageal echocardiography ,TEE）获取的一组真实的临床数据的分析，认识TEE在心房颤动患者左心耳封堵术中及随访中的应用价值。方法 选取2015年3月至2017年4月于我院确诊房颤且行WATCHMAN左心耳经皮介入封堵术的患者为对象，通过TEE观察记录术中、随访45天、6个月封堵器效果，包括残余分流、有无血栓及封堵器压缩径。结果 共收集243例行左心耳经皮介入封堵术的房颤病例，成功植入WATCHMAN封堵器的病例为241例（99.2%），围术期发现心脏压塞2例（0.83%），发现器械血栓1例（0.41%）；随访45天时，发现器械血栓3例（1.36%）;随访6个月时，未发生器械相关血栓事件、死亡等重大不良事件。结论 TEE在WATCHMAN左心耳封堵术中及术后起到了重要的作用，其对手术效果及术后并发症的评估准确、客观、及时，值得推荐临床应用。

The clinical application value of transesophageal echocardiography in percutaneous the Watchman left atrial appendage closure

Object Through the analysis of a series of real clinical data acquired by transesophageal echocardiography (TEE), we know the value of transesophageal echocardiography in the treatment of left atrial appendage and its follow-up. Methods From March 2015 to April 2017 in our hospital diagnosed atrial fibrillation and WATCHMAN left atrial appendage percutaneous closure of patients as the object and through transesophageal echocardiography to observe and record the operation, followed up 45 days, 6 Month occluder effect, including residual shunt, with or without thrombus and occluder compression diameter. Results A total of 243 cases of atrial fibrillation underwent percutaneous balloon occlusion of the left atrial appendage were collected. 241 cases (99.2%) were successfully implanted WATCHMAN occluder. Pericardial tamponade was found in 2 cases (0.83%) and found Thrombosis occurred in 1 patient (0.41%). After 45 days of follow-up, 3 patients (1.36%) had thrombosis, and no significant device-related thrombosis and death occurred at 6 months follow-up. Conclusion The transesophageal echocardiography played an important role in the WATCHMAN left atrial appendage occlusion and postoperative follow-up. The evaluation of the surgical effect and postoperative complications is objective, timely and worth recommending clinical application.