经食道超声心动图、双源螺旋CT及左心耳造影在左心耳封堵术中的应用现状

经皮左心耳封堵术(LAAO)作为具有高出血风险的非瓣膜性房颤患者一种新的治疗选择,随着经验的不断提高,总体植入成功率也一直在上升.在手术的各个时期,常需要通过不同的影像学进行评估,其中常用的包括经食道超声心动图(TEE)、双源螺旋CT以及左心耳造影(LAA-A).术前一般采用TEE或CT来评估左心耳(LAA)形态功能及判断手术适应证;术中则常以TEE和LAA-A来监测手术过程,为封堵器安全释放提供支持;术后还可以根据TEE或CT的随访检查结果,来制定后续治疗计划.本文对目前三种影像学方法在左心耳封堵术中的应用现状进行综述.

Application of transesophageal echocardiography, dual source spiral CT and left atrial appendage angiography in left atrial appendage occlusion

Percutaneous left atrial appendage occlusion (LAAO) as a new treatment strategy for patients with nonvalvular atrial fibrillation with high bleeding risk, the success rate of implantation has been increasing with the continuous improvement of experience. Patients are often evaluated by different imaging methods during and after the surgery, including transesophageal echocardiography (TEE), dual source spiral CT, left atrial appendage angiography (LAA-A). TEE or CT is performed to evaluate the morphology and function of left atrial appendage (LAA), and surgical indications before the surgery. Intraoperative TEE and LAA-A are performed to monitor the surgical process and provide support for the safe release of plug device. After the surgery, the treatment plan shall be formulated according to the follow-up results of TEE or CT. This paper reviews the application status of the three imaging methods in left atrial appendage occlusion.