Fusion Imaging of X-ray and Transesophageal Echocardiography Improves the Procedure of Left Atrial Appendage Closure.
Fusion Imaging of X-ray and Transesophageal Echocardiography Improves the Procedure of Left Atrial Appendage Closure.
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DOI：
10.1007/s10557-020-07048-z
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发表时间：
2020-12
影响因子：
3.4
通讯作者：
Röhl P
中科院分区：
文献类型：
--
作者：
Ebelt H;Domagala T;Offhaus A;Wiora M;Schwenzky A;Hoyme M;Anacker J;Röhl P
左心耳封堵术（LAAC）是针对有血栓栓塞事件风险且被认为不适合口服抗凝（OAC）的房颤患者的替代治疗策略。LAAC主要在经食管超声心动图（TEE）和透视引导下进行。本文介绍的研究应分析LAAC期间进行的经食管超声心动图和X线融合成像（FI）是否可行，是否可以改善手术结果。本文提供的数据来自一项回顾性单中心研究。样本量定义为50例未使用融合成像进行LAAC的患者（对照组）和25例使用融合成像引导LAAC手术的患者（治疗组）。入选标准定义为年龄> 18岁，完成LAAC手术定义为展开WATCHMAN 2.5 LAA封堵器。研究终点分别为手术时间、造影剂用量、辐射剂量、TEE中WATCHMAN的最终位置（偏离理想位置）和临床终点。所有患者均成功进行了左心耳封堵术。未发生器械栓塞，无患者发生围手术期卒中/TIA或全身性栓塞。应用融合成像的患者组的平均手术时间缩短15分钟（p < 0.001）。此外，融合成像的使用与造影剂的显著减少相关（比对照组少20.6 ml; p < 0.045）。关于WATCHMAN的最终位置，未发现组间存在相关差异。融合成像的使用显著减少了LAAC患者的手术时间和造影剂用量。
Left atrial appendage closure (LAAC) is an alternative treatment strategy for patients with atrial fibrillation who are at risk for thromboembolic events and considered not suitable for oral anticoagulation (OAC). LAAC is mainly performed under the guidance of transesophageal echocardiography (TEE) and fluoroscopy. The study presented here should analyze whether fusion imaging (FI) of transesophageal echocardiography and X-ray performed during LAAC is feasible and can improve the results of the procedure. The data presented here are from a retrospective single center study. Sample size was defined as 50 patients in which LAAC was performed without fusion imaging (control group) and 25 patients were the LAAC procedure was guided by fusion imaging (treatment group). Inclusion criteria were defined as age > 18 years and completion of an LAAC procedure defined as deployment of a WATCHMAN 2.5 LAA occluder. Study endpoints were procedure time, amount of used contrast medium, radiation dose, final position of the WATCHMAN in TEE (deviation from ideal positioning), and clinical endpoints, respectively. LAA closure was successfully performed in all patients. No case of device embolism was occurring, and none of the patients experienced a periprocedural stroke/TIA nor a systemic embolism, respectively. Mean procedure time was 15 min shorter in the group of patients where fusion imaging was applied (p < 0.001). Additionally, the use of fusion imaging was associated with a significant reduction of contrast medium (20.6 ml less than in control; p < 0.045). Regarding the final position of the WATCHMAN, no relevant differences were found between the groups. The use of fusion imaging significantly reduced procedure time and the amount of contrast medium in patients undergoing LAAC.
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影响因子：
24
作者：
Reddy, Vivek Y.;Gibson, Douglas N.;Holmes, David R.
通讯作者：
Holmes, David R.
DOI：
10.1016/j.echo.2017.05.001
发表时间：
2017-09-01
影响因子：
6.5
作者：
Faletra, Francesco F.;Biasco, Luigi;Monaghan, Mark J.
通讯作者：
Monaghan, Mark J.
DOI：
10.1111/echo.14415
发表时间：
2019-07-01
影响因子：
1.5
作者：
Ribeiro, Joana Maria;Teixeira, Rogerio;Goncalves, Lino
通讯作者：
Goncalves, Lino
影响因子：
2
作者：
Afzal, S.;Veulemans, V.;Zeus, T.
通讯作者：
Zeus, T.
影响因子：
3.7
作者：
Jungen C;Zeus T;Balzer J;Eickholt C;Petersen M;Kehmeier E;Veulemans V;Kelm M;Willems S;Meyer C
通讯作者：
Meyer C