Thoracoscopic stapler-and-loop technique for left atrial appendage closure in nonvalvular atrial fibrillation: Mid-term outcomes in 201 patients

医学 心房颤动 外科 心脏病学 中止 华法林 心耳 心包积液 内科学 冲程(发动机)
作者
Toshiya Ohtsuka,Takahiro Nonaka,Motoyuki Hisagi,Mikio Ninomiya,Ai Masukawa,Takahiro Ota
出处
期刊:Heart Rhythm [Elsevier]
卷期号:15 (9): 1314-1320 被引量:8
标识
DOI:10.1016/j.hrthm.2018.05.026
摘要

Background Left atrial appendage (LAA) closure can be an alternative to oral anticoagulation to prevent cardiogenic thromboembolisms in patients with nonvalvular atrial fibrillation. Objective The purpose of this study was to retrospectively evaluate the safety, completeness, and mid-term prevention of our thoracoscopic stapler-and-loop technique for LAA closure. Methods Patients operated on between October 2008 and February 2017 were reviewed. Endoscopic stapler and ligation loops were used. Patients received 1 month of anticoagulation before discontinuation. Hospital death and procedure-related major complications (thromboembolism, hemorrhagic events, phrenic palsy) were the primary composite endpoint for safety, and cardiogenic thromboembolisms were the endpoint for prevention. Brain magnetic resonance imaging investigated new thromboembolic spots 1 year after surgery. Results There were 201 patients (118 men, 83 women) with a mean age of 74 years (range 68–94) years, mean CHA2DS2-VASc score (± SD) 4.1 ±1.4, and mean HAS-BLED score 2.9 ± 1.0. Mean operation time was 28 minutes. All LAAs were removed, and intraoperative transesophageal echocardiography confirmed completeness of the closure in each patient. No hospital deaths or major procedure-related complications occurred. Follow-up results for 198 patients (98%) over a mean period of 48 months (range 12–110) revealed that 2 patients developed cardiogenic thromboembolisms (0.25 event per 100 patient-years). Magnetic resonance imaging of 51 patients with a mean CHA2DS2-VASc score of 4.7 ± 1.6 revealed 1 new small spot in each of 2 patients (3.9%; 3.9 spots per 100 patient-years). Conclusion Our thoracoscopic stapler-and-loop technique swiftly, safely, and completely closed LAAs in patients with nonvalvular atrial fibrillation and provided acceptable mid-term prevention without anticoagulation.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
汉堡包应助科研通管家采纳,获得10
刚刚
栗子应助科研通管家采纳,获得10
1秒前
坚强的哈密瓜完成签到,获得积分10
1秒前
猫会后空翻完成签到 ,获得积分10
1秒前
酷波er应助科研通管家采纳,获得10
1秒前
脑洞疼应助科研通管家采纳,获得10
1秒前
个性语堂应助科研通管家采纳,获得10
1秒前
yao应助科研通管家采纳,获得10
1秒前
烟花应助科研通管家采纳,获得10
1秒前
CodeCraft应助科研通管家采纳,获得10
1秒前
热气球应助科研通管家采纳,获得10
1秒前
乐乐应助科研通管家采纳,获得10
1秒前
香蕉觅云应助科研通管家采纳,获得10
1秒前
cdercder应助科研通管家采纳,获得30
1秒前
充电宝应助科研通管家采纳,获得10
1秒前
李爱国应助科研通管家采纳,获得10
1秒前
FashionBoy应助科研通管家采纳,获得10
1秒前
英俊的铭应助科研通管家采纳,获得10
1秒前
南北应助科研通管家采纳,获得10
1秒前
大刀开口完成签到,获得积分10
1秒前
Owen应助科研通管家采纳,获得10
1秒前
丘比特应助科研通管家采纳,获得10
1秒前
hzc应助科研通管家采纳,获得10
1秒前
充电宝应助科研通管家采纳,获得10
2秒前
2秒前
852应助科研通管家采纳,获得10
2秒前
咕咕发布了新的文献求助10
2秒前
violinsj完成签到,获得积分0
2秒前
ykyin发布了新的文献求助10
2秒前
nz发布了新的文献求助30
3秒前
Jrssion完成签到,获得积分10
4秒前
直率的钢铁侠完成签到,获得积分10
5秒前
MiSD完成签到,获得积分10
6秒前
大刀开口发布了新的文献求助30
7秒前
wj18637196763完成签到,获得积分10
8秒前
香蕉觅云应助zxj采纳,获得10
8秒前
8秒前
南医李云龙完成签到,获得积分20
9秒前
CodeCraft应助biofresh采纳,获得30
9秒前
Jeamren完成签到,获得积分10
11秒前
高分求助中
Continuum Thermodynamics and Material Modelling 3000
Production Logging: Theoretical and Interpretive Elements 2700
Les Mantodea de Guyane Insecta, Polyneoptera 1000
Structural Load Modelling and Combination for Performance and Safety Evaluation 1000
Conference Record, IAS Annual Meeting 1977 820
電気学会論文誌D(産業応用部門誌), 141 巻, 11 号 510
Typology of Conditional Constructions 500
热门求助领域 (近24小时)
化学 材料科学 生物 医学 工程类 有机化学 生物化学 物理 纳米技术 计算机科学 内科学 化学工程 复合材料 基因 遗传学 物理化学 催化作用 量子力学 光电子学 冶金
热门帖子
关注 科研通微信公众号,转发送积分 3571662
求助须知:如何正确求助?哪些是违规求助? 3142176
关于积分的说明 9445995
捐赠科研通 2843587
什么是DOI,文献DOI怎么找? 1562944
邀请新用户注册赠送积分活动 731458
科研通“疑难数据库(出版商)”最低求助积分说明 718551