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Percutaneous left atrial appendage closure with the AMPLATZER cardiac plug device in patients with nonvalvular atrial fibrillation and contraindications to anticoagulation therapy.
AMPLATZER 心塞装置经皮左心耳封堵术治疗非瓣膜性心房颤动患者及抗凝治疗禁忌证。

摘要

OBJECTIVES:The aim of this study was to evaluate the results associated with left atrial appendage closure (LAAC) with the AMPLATZER Cardiac Plug (ACP) (St. Jude Medical, Minneapolis, Minnesota) in patients with nonvalvular atrial fibrillation and absolute contraindications to anticoagulation therapy.
BACKGROUND:Few data exist on the late outcomes after LAAC in patients with absolute contraindications to warfarin.
METHODS:A total of 52 patients with nonvalvular atrial fibrillation underwent LAAC with the ACP device in 7 Canadian centers. Most patients received short-term (1 to 3 months) dual-antiplatelet therapy after the procedure and single-antiplatelet therapy thereafter. A transesophageal echocardiography was performed in 74% of patients at the 6-month follow-up. No patient was lost to follow-up (≥ 12 months in all patients).
RESULTS:The mean age and median (interquartile range) CHADS2 score were 74 ± 8 years and 3 (2 to 4), respectively. The procedure was successful in 98.1% of the patients, and the main complications were device embolization (1.9%) and pericardial effusion (1.9%), with no cases of periprocedural stroke. At a mean follow-up of 20 ± 5 months, the rates of death, stroke, systemic embolism, pericardial effusion, and major bleeding were 5.8%, 1.9%, 0%, 1.9%, and 1.9%, respectively. The presence of mild peridevice leak was observed in 16.2% of patients at the 6-month follow-up as evaluated by transesophageal echocardiography. There were no cases of device thrombosis.
CONCLUSIONS:In patients with nonvalvular atrial fibrillation at high risk of cardioembolic events and absolute contraindications to anticoagulation, LAAC using the ACP device followed by dual-/single-antiplatelet therapy was associated with a low rate of embolic and bleeding events after a mean follow-up of 20 months. No cases of severe residual leak or device thrombosis were observed at the 6-month follow-up.

译文

目的: 本研究的目的是评估与左心耳封堵术 (LAAC) 和 AMPLATZER 心脏塞 (ACP) 相关的结果 (明尼苏达州明尼阿波利斯圣裘德医疗公司) 非瓣膜性心房颤动患者和抗凝治疗的绝对禁忌症。
背景: 关于华法林绝对禁忌症患者 LAAC 治疗后的后期结局的数据很少。
方法: 在 7 个加拿大中心,共有 52 名非瓣膜性心房颤动患者使用 ACP 设备接受 LAAC。大多数患者在手术后接受短期 (1 至 3 个月) 双抗血小板治疗,之后接受单抗血小板治疗。在 6 个月的随访中,74% 的患者进行了经食管超声心动图检查。没有患者失去随访 (所有患者 ≥ 12 个月)。
结果: 平均年龄和中位数 (四分位数间) CHADS2 得分分别为 74 ± 8 岁和 3 (2-4) 岁。98.1% 的患者手术成功,主要并发症为装置栓塞 (1.9%) 和心包积液 (1.9%),无围手术期中风病例。平均随访 20 ± 5 个月,死亡率、中风、全身性栓塞、心包积液和大出血分别为 5.8% 、 1.9% 、 0% 、 1.9% 和 1.9%, 分别。在 6 个月的随访中,通过经食管超声心动图评估,在 16.2% 的患者中观察到存在轻微的装置周围渗漏。没有设备血栓形成的病例。
结论: 非瓣膜性心房颤动患者发生心脏栓塞事件的风险高,且有绝对的抗凝禁忌症, 在平均随访 20 个月后,使用 ACP 装置并接受双/单抗血小板治疗的 LAAC 与低栓塞率和出血事件相关。在 6 个月的随访中,未观察到严重残余泄漏或设备血栓形成的病例。

Amplatzer cardiac plug

心血管 封堵器 治疗方法
概述  :  

Amplatzer双面伞封堵器于1997年应用于临床,由于其结构上的特点,增加了使用的安全性,提高了成功率,术后残余分流的发生率低,操作方便。在释放前,当盘片选择不合适时也容易退回导管鞘内,便于取出。应用该盘片能闭合较大直径的房间隔缺损,有报道此封堵器成功闭合缺口直径40 mm的房间隔缺损。术后并发症的发生率低,术后近4年的随访中,无不良反应,初步临床应用结果表明,疗效可靠、安全,可以作为继发孔型房间隔缺损首选治疗方法。Amplatzer房间隔封堵器是由高弹性镍钛合金丝编织的双面盘

Amplatzer

       蘑菇伞形;蘑菇伞;封堵;封堵器

       In operation, life indexes and Amplatzer occluder position were closely observed. 

术中严密监护生命体征,观察封堵器定位情况。

 

Cardiac 英 ['kɑːdɪæk]  美 ['kɑrdɪæk] 

       adj. 心脏的,心脏病的;(与)贲门(有关)的

n. (非正式)心脏病患者;强心剂

      cardiac output 心输出量  cardiac muscle n. [解]心肌

       Sudden cardiac arrest can strike anyone at any time, no matter their age or

 health status. 

心脏骤停可以在任何时候袭击任何人,不论他们的年龄或健康状况。

 

Plug 英 [plʌg]  美 [plʌɡ] 

       n. 插头;塞子;栓

vi. 塞住;用插头将与电源接通

vt. 插入;塞住;接插头

      plug in 插入;插上电源   spark plug n. 火花塞;带头人;中坚分子

同根词   adj. plugged 堵塞的;塞紧的

n. plugger (牙齿)填塞物;苦干的人;宣传员;广告播音员

       Where can I find the plug? 

我可以在哪里找到插座?


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