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Eur Heart J-Card Img：经皮左心耳封堵术后左心耳通畅和装置相关血栓分析

2018-02-11 xing.T MedSci原创

LAA封堵术左心耳通畅装置相关血栓
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由此可见，LAA封堵术后CT上出现LAA通畅较为常见，特别是在静脉期图像中。泄漏与基线时与LA/LAA大小、随访后设备错位以及不完全血栓形成有关。DRT也相当普遍，但很难通过病人和设备相关因素进行预测。

经皮左心耳（LAA）封堵术后经食管超声心动图的研究报道会频繁发生设备周围泄漏和设备相关的血栓（DRT）。近日，心血管领域权威杂志Eur Heart J-Card Img上发表了一篇研究文章，研究人员旨在评估LAA封堵术后在心脏计算机断层扫描上出现设备周围泄漏和DRT的患病率、特性和相关因素。

研究人员在受试者LAA封堵术之前进行心脏CT检查以评估左心房（LA）容积、LAA形状、着陆区直径。3个月后进行CT复查以评估植入设备标准、设备泄漏和DRT。CT检查结果与患者和设备特征以及随访结局有关。

一百一十七例患者（74±9岁, 37 %为女性，CHA2DS2VASC为4.4 ± 1.3以及HASBLED为3.5 ± 1）接受心脏植入Amplatzer堵塞（ACP）/Amulet（71%）或Watchman（29%）。在动脉期CT图像有44%和静脉期图像有69%患者检测到LAA通畅。最常见的泄漏位于后下部。LAA通畅与LA扩张、左心室射血分数降低、非鸡翅形LAA、较大的着陆区直径、不完全装置瓣膜血栓和盘/瓣膜错位有关。19例（16%）患者发现了DRT，位于层压和前上位置。DRT与临床和影像学特征以及植入标准无关，但与设备瓣膜整体血栓形成相关。在平均13个月的随访期间，发生卒中/短暂性脑缺血发作的患者有8例，与DRT或LAA通畅无关。

由此可见，LAA封堵术后CT上出现LAA通畅较为常见，特别是在静脉期图像中。泄漏与基线时与LA/LAA大小、随访后设备错位以及不完全血栓形成有关。DRT也相当普遍，但很难通过病人和设备相关因素进行预测。

原始出处：

Hubert Cochet,et al.Left atrial appendage patency and device-related thrombus after percutaneous left atrial appendage occlusion: a computed tomography study. Eur Heart J-Card Img. 2018. https://doi.org/10.1093/ehjci/jey010

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    2018-09-12 仁心济世

    #装置相关血栓#

    0

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    2018-12-29 ycmayy

    #封堵术#

    0

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    2018-04-05 zwjnj2

    好好学习学习学习学习

    0

  4. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1455596, encodeId=09da1455596cd, content=<a href='/topic/show?id=d15a4808371' target=_blank style='color:#2F92EE;'>#左心耳#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48083, encryptionId=d15a4808371, topicName=左心耳)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=386b5684768, createdName=jxrzshh, createdTime=Tue Feb 13 07:54:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562836, encodeId=133e15628361b, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Tue Feb 13 07:54:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=287273, encodeId=753528e2730e, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Mon Feb 12 06:58:34 CST 2018, time=2018-02-12, status=1, ipAttribution=)]
    2018-04-03 zwjnj2

    好好好学习学习学习

    0

  5. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1455596, encodeId=09da1455596cd, content=<a href='/topic/show?id=d15a4808371' target=_blank style='color:#2F92EE;'>#左心耳#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48083, encryptionId=d15a4808371, topicName=左心耳)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=386b5684768, createdName=jxrzshh, createdTime=Tue Feb 13 07:54:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562836, encodeId=133e15628361b, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Tue Feb 13 07:54:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=287273, encodeId=753528e2730e, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Mon Feb 12 06:58:34 CST 2018, time=2018-02-12, status=1, ipAttribution=)]
    2018-02-24 zwjnj2

    好好好学习学习

    0

  6. 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href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Feb 13 07:54:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1360707, encodeId=b3db1360e070e, content=<a href='/topic/show?id=9a9b4808877' target=_blank style='color:#2F92EE;'>#左心耳封堵术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48088, encryptionId=9a9b4808877, topicName=左心耳封堵术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f34c147, createdName=ay2000fy, createdTime=Tue Feb 13 07:54:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1455596, encodeId=09da1455596cd, content=<a href='/topic/show?id=d15a4808371' target=_blank style='color:#2F92EE;'>#左心耳#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48083, encryptionId=d15a4808371, topicName=左心耳)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=386b5684768, createdName=jxrzshh, createdTime=Tue Feb 13 07:54:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562836, encodeId=133e15628361b, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Tue Feb 13 07:54:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=287273, encodeId=753528e2730e, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Mon Feb 12 06:58:34 CST 2018, time=2018-02-12, status=1, ipAttribution=)]
    2018-02-13 zhaojie88

    #ART#

    0

  7. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1455596, encodeId=09da1455596cd, content=<a href='/topic/show?id=d15a4808371' target=_blank style='color:#2F92EE;'>#左心耳#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48083, encryptionId=d15a4808371, topicName=左心耳)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=386b5684768, createdName=jxrzshh, createdTime=Tue Feb 13 07:54:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562836, encodeId=133e15628361b, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Tue Feb 13 07:54:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=287273, encodeId=753528e2730e, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Mon Feb 12 06:58:34 CST 2018, time=2018-02-12, status=1, ipAttribution=)]
    2018-02-13 ay2000fy

    #左心耳封堵术#

    0

  8. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1455596, encodeId=09da1455596cd, content=<a href='/topic/show?id=d15a4808371' target=_blank style='color:#2F92EE;'>#左心耳#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48083, encryptionId=d15a4808371, topicName=左心耳)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=386b5684768, createdName=jxrzshh, createdTime=Tue Feb 13 07:54:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562836, encodeId=133e15628361b, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Tue Feb 13 07:54:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=287273, encodeId=753528e2730e, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Mon Feb 12 06:58:34 CST 2018, time=2018-02-12, status=1, ipAttribution=)]
    2018-02-13 jxrzshh

    #左心耳#

    0

  9. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1455596, encodeId=09da1455596cd, content=<a href='/topic/show?id=d15a4808371' target=_blank style='color:#2F92EE;'>#左心耳#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48083, encryptionId=d15a4808371, topicName=左心耳)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=386b5684768, createdName=jxrzshh, createdTime=Tue Feb 13 07:54:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562836, encodeId=133e15628361b, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Tue Feb 13 07:54:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=287273, encodeId=753528e2730e, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Mon Feb 12 06:58:34 CST 2018, time=2018-02-12, status=1, ipAttribution=)]
    2018-02-13 slcumt

    #HEART#

    0

  10. 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href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Feb 13 07:54:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1360707, encodeId=b3db1360e070e, content=<a href='/topic/show?id=9a9b4808877' target=_blank style='color:#2F92EE;'>#左心耳封堵术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48088, encryptionId=9a9b4808877, topicName=左心耳封堵术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f34c147, createdName=ay2000fy, createdTime=Tue Feb 13 07:54:00 CST 2018, time=2018-02-13, status=1, 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createdBy=80d715270048, createdName=slcumt, createdTime=Tue Feb 13 07:54:00 CST 2018, time=2018-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=287273, encodeId=753528e2730e, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Mon Feb 12 06:58:34 CST 2018, time=2018-02-12, status=1, ipAttribution=)]
    2018-02-12 1209e435m98(暂无昵称)

    学习了.谢谢分享

    0

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