房间隔缺损或卵圆孔未闭联合左心耳一站式封堵治疗的安全及有效性

目的 评估先天性房间隔缺损或卵圆孔未闭并发心房颤动(房颤)患者同时行房间隔缺损或卵圆孔未闭联合左心耳封堵术的安全性、疗效及预后.方法 回顾性分析珠海市人民医院2017年10月至2019年6月收治的10例先天性房间隔缺损或卵圆孔未闭并发房颤的患者的术前、术中及术后临床资料,评估术中安全性及即刻手术疗效,并于术后的第45天...

Safety and efficacy of one-stop treatment of left atrial appendage occlusion in combination with concomitant closure of atrial septum defect or patent foramen ovale

Objectives To explore the feasibility,safety and efficacy of one-stop treatment of left atrial appendage(LAA)occlusion(LAAO)in combination with concomitant closure of atrial septum defect(ASD)or patent foramen ovale(PFO)in patients with ASD or PFO and concurrent atrial fibrillation(AF).Methods Clinical data of 10 ASD or PFO patients with concurrent AF admitted to Zhuhai People′s Hospital from October 2017 to June 2019 were retrospectively analyzed.The effects of closure of LAA and ASD or PFO were evaluated immediately after operation.The location,exterior thrombosis status and residual leak of the occluders of LAA and ASD or PFO in parallel with patients′clinical manifestations were evaluated on the 45 th,90 th,180 th,360 thdays of follow-up.Results All the patients were successfully implanted with WATCHMANTMdevice and double-plate ASD or PFO occluder,within which,5 patients received ASD occluder and the other 5 patients received PFO occluder(3 of the latter underwent simultaneous radiofrequency ablation of AF).The WATCHMANTMdevice operation was in accordance with the PASS principle.An instant and satisfactory sealing by WATCHMANTMand ASD or PFO occluders were obtained upon operation:all occluders were fixed in proper position with no residual shunts.And there was no exterior device thrombosis,cardiac tamponade or vascular complications throughout the operation.The follow-up results showed that all the 10 patients were protected from newly developed ischemic or hemorrhagic stroke,angina pectoris,myocardial infarction and worsening heart function.Meanwhile,there was no displacement,surface thrombosis or gradual residual leak of the devices.Sinus rhythm had been maintained with improved cardiac function in the 3 patients undergone concomitant radiofrequency ablation,and another patient had spontaneous cardioversion to normal heart rhythm.Conclusions For congenital ASD or PFO patients concurrent with non-valvular AF,one-stop treatment of concomitant ASD or PFO and LAAO is safe and convenient with favorable short-and mid-term clinical outcomes,thus being a feasible and promising strategy for treatment of this cohorts.