张萌,何文,杜丽娟,兰亭玉,吕一飞,张惠琴,段凤霞,张巍.经食管超声心动图引导以LAmbre封堵器封堵左心耳[J].中国医学影像技术,2024,40(2):177~181
经食管超声心动图引导以LAmbre封堵器封堵左心耳
Transesophageal echocardiography for guiding left atrial appendage closure with LAmbre occluder
投稿时间:2023-09-27  修订日期:2024-01-08
DOI:10.13929/j.issn.1003-3289.2024.02.004
中文关键词:  心房颤动  间隔封堵器  超声检查  左心耳
英文关键词:atrial fibrillation  septal occluder device  ultrasonography  left auricle
基金项目:
作者单位E-mail
张萌 首都医科大学附属北京天坛医院超声科, 北京 100070  
何文 首都医科大学附属北京天坛医院超声科, 北京 100070  
杜丽娟 首都医科大学附属北京天坛医院超声科, 北京 100070  
兰亭玉 首都医科大学附属北京天坛医院超声科, 北京 100070  
吕一飞 首都医科大学附属北京天坛医院超声科, 北京 100070  
张惠琴 首都医科大学附属北京天坛医院超声科, 北京 100070  
段凤霞 首都医科大学附属北京天坛医院超声科, 北京 100070  
张巍 首都医科大学附属北京天坛医院超声科, 北京 100070 ultrazw@sina.com 
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中文摘要:
      目的 观察经食管超声心动图(TEE)引导以LAmbre封堵器行左心耳封堵(LAAC)的价值。方法 回顾性分析40例接受以LAmbre封堵器行LACC的非瓣膜性心房颤动(NVAF)患者,对比治疗前CT血管造影(CTA)、治疗中TEE及数字减影血管造影(DSA)所见,分析其所测锚定区直径和左心耳开口直径与封堵器型号的相关性,以及TEE与DSA评估封堵器周围漏(PDL)的差异。结果 40例均成功植入LAmbre封堵器。固定伞直径与CTA、TEE及DSA所测锚定区直径均呈正相关(r=0.79、0.82、0.91,P均<0.01);封堵伞直径与CTA、TEE及DSA所测左心耳开口直径均呈正相关(r=0.56、0.89、0.86,P均<0.01)。LAAC中释放封堵器后即刻16例出现PDL,TEE和DSA均可检出;24例TEE及DSA均未见PDL。结论 TEE用于引导以LAmbre封堵器行LAAC的价值与DSA相当。
英文摘要:
      Objective To observe the value of transesophageal echocardiography (TEE) for guiding left atrial appendage closure (LAAC) with LAmbre occluder. Methods Data of 40 non-valvular atrial fibrillation (NVAF) patients who underwent LAAC with LAmbre occluder were retrospectively analyzed. CT angiography (CTA) before treatment, TEE and digital subtraction angiography (DSA) findings during LAAC were comparatively observed, and the correlations of the anchor area diameter and left atrial appendage opening diameter measured with the above three as well as occluder size were analyzed, and TEE and DSA for evaluating peri-device leak (PDL) were compared. Results LAAC were successfully performed with LAmbre occlude in all 40 cases. The diameter of the fixed umbrella was positively correlated with anchor area diameter measured with CTA, TEE and DSA (r=0.79, 0.82, 0.91, all P<0.01), of occlusion umbrella was positively correlated with left atrial appendage opening diameter measured with CTA, TEE and DSA (r=0.56, 0.89, 0.86, all P<0.01). Immediately after the release of occluder in LAAC, PDL occurred in 16 cases and were detected with both TEE and DSA, while in the rest 24 cases no PDL was found with neither TEE nor DSA. Conclusion TEE had comparable value to DSA for guiding LAAC using LAmbre occluder.
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