储慧民 杜先锋 宁波市第一医院 心律失常诊疗中心
X轴,ICE探头置于左上肺静脉(LSPV),自后向前扫描LAA及封堵器(图2左列);
Z轴,ICE探头置于二尖瓣环口部(MAO),自下向上扫描LAA及封堵器(图2右列)。
图2. ICE指导下的LAAC极简术式。左、中、右三列分别为X轴、Y轴、Z轴方向ICE对LAA及Watchman封堵器进行扫描。上排为ICE图像,下排为ICE探头所处的三个关键解剖学位置,分别为LSPV、RPVO、MAO,黄色虚线圈为ICE探头。LAAC,左心耳封堵;ICE,心腔内超声心动图;LSPV,左上肺静脉;RPVO,右肺静脉口部;MAO,二尖瓣环口部;WM,Watchman封堵器;LAO,左前斜位;RAO,右前斜位。
总 结
▼参考文献
1.Reddy VY, Doshi SK, Kar S, Gibson DN, Price MJ, Huber K, Horton RP, Buchbinder M, Neuzil P, Gordon NT and Holmes DR, Jr. 5-Year Outcomes After Left Atrial Appendage Closure: From the PREVAIL and PROTECT AF Trials. Journal of the American College of Cardiology. 2017;70:2964-2975.
2.Panikker S, Lord J, Jarman JW, Armstrong S, Jones DG, Haldar S, Butcher C, Khan H, Mantziari L, Nicol E, Hussain W, Clague JR, Foran JP, Markides V and Wong T. Outcomes and costs of left atrial appendage closure from randomized controlled trial and real-world experience relative to oral anticoagulation. European heart journal. 2016;37:3470-3482.
3.Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström-Lundqvist C, Boriani G, Castella M, Dan G-A, Dilaveris PE, Fauchier L, Filippatos G, Kalman JM, La Meir M, Lane DA, Lebeau J-P, Lettino M, Lip GYH, Pinto FJ, Thomas GN, Valgimigli M, Van Gelder IC, Van Putte BP and Watkins CL. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). European heart journal. 2021;42:373-498.
4.January CT, Wann LS, Calkins H, Chen LY, Cigarroa JE, Cleveland JC, Jr., Ellinor PT, Ezekowitz MD, Field ME, Furie KL, Heidenreich PA, Murray KT, Shea JB, Tracy CM and Yancy CW. 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society in Collaboration With the Society of Thoracic Surgeons. Circulation. 2019;140:e125-e151.
5.黄从新, 张澍, 黄德嘉 and 华伟等. 左心耳干预预防心房颤动患者血栓栓塞事件:目前的认识和建议(2019). 中华心律失常学杂志. 2019;23:372-392.
6.中华心血管病杂志编辑委员会 中. 中国左心耳封堵预防心房颤动卒中专家共识(2019). 中华心血管病杂志. 2019;47:937-955.
7.Freitas-Ferraz AB, Bernier M, Vaillancourt R, Ugalde PA, Nicodème F, Paradis J-M, Champagne J, O'Hara G, Junquera L, Del Val D, Muntané-Carol G, O'Connor K, Beaudoin J and Rodés-Cabau J. Safety of Transesophageal Echocardiography to Guide Structural Cardiac Interventions. Journal of the American College of Cardiology. 2020;75:3164-3173.
8.So CY, Lam YY, Cheung GS, Chan CKY, Chen S, Chan AK, Park JW, Schmidt B and Yan BP. Minimalistic Approach to Left Atrial Appendage Occlusion Using the LAmbre Device. JACC Cardiovascular interventions. 2018;11:1113-1114.
9.O'Brien B, Zafar H, De Freitas S and Sharif F. Transseptal puncture - Review of anatomy, techniques, complications and challenges. International journal of cardiology. 2017;233:12-22.
10.Zhang X, Jin Q, Kong D, Jiang Y, Chen S, Chen D, Hou CR, Zhang L, Pan C, Zhou D and Ge J. Comparison of fluoroscopy and transesophageal echocardiogram for intra-procedure device surveillance assessment during implantation of Watchman. International journal of cardiology. 2021;324:72-77.
11.Berti S, Paradossi U, Meucci F, Trianni G, Tzikas A, Rezzaghi M, Stolkova M, Palmieri C, Mori F and Santoro G. Periprocedural intracardiac echocardiography for left atrial appendage closure: a dual-center experience. JACC Cardiovascular interventions. 2014;7:1036-44.
12.卓伟东,杜先锋,储慧民. 心腔内超声心动图在经皮左心耳封堵术中的应用和进展. 中华心律失常学杂志. 2020;24:276-279.
13.Chu H, Du X, Shen C, He B, Feng M, Liu J, Fu G and Wang B. Left atrial appendage closure with zero fluoroscopic exposure via intracardiac echocardiographic guidance. Journal of the Formosan Medical Association = Taiwan yi zhi. 2020;119:1586-1592.
专家简介
储慧民 宁波市第一医院
硕士研究生导师,宁波市第一医院心律失常诊疗中心主任,国家卫计委心律失常介入治疗培训导师,国家卫健委房颤卒中防治专业委员会委员、中国医师协会心律学专业委员会委员、中国医促会心律学分会常务委员、中国绿色电生理联盟常务委员、中华医学会心电生理与起搏分会心房颤动工作组、室性心律失常工作组委员,中国生物工程学会心律学分会全国委员等学术团体职务,《中华心律失常学杂志》编委,国家卫计委《医学参考报》心律频道编委,欧洲心律学会会员。从事心内科临床工作近20年,擅长心脏电生理和起搏器植入,左心耳封堵以及先心病介入治疗,累计完成心律失常射频消融10000余例。帮助4个国家和30个省市300多家医院开展心律失常介入治疗。
(来源:《国际循环》编辑部)
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