Left Atrial Appendage Closure Guided by Integrated Echocardiography and Fluoroscopy Imaging Reduces Radiation Exposure.
Left Atrial Appendage Closure Guided by Integrated Echocardiography and Fluoroscopy Imaging Reduces Radiation Exposure.
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DOI：
10.1371/journal.pone.0140386
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Meyer C
中科院分区：
文献类型：
--
作者：
Jungen C;Zeus T;Balzer J;Eickholt C;Petersen M;Kehmeier E;Veulemans V;Kelm M;Willems S;Meyer C
旨在研究在2D/3D经食管超声心动图（TEE）和荧光透视成像自动实时集成指导下经皮左心耳（LAA）封堵术是否可减少辐射暴露。在这项开放标签单中心研究中，34名连续患者（8名女性; 73.1±8.5岁）在使用（n = 17，EN+）或未使用（n = 17，EN-）集成超声心动图/荧光透视成像引导（EchoNavigator® [EN]; Philips Healthcare）的情况下进行了左心耳封堵术（Amplatzer？左心耳封堵器）。两组之间的基线特征无显著差异。所有患者均记录了成功的左心耳封堵术。EN+组的放射剂量减少约52%（EN+：48.5±30.7 vs. EN-：93.9±64.4戈伊/cm 2; p = 0.01）。与辐射剂量相对应，透视时间缩短（EN+：16.7±7 vs. EN-：24.0±11.4 min; p = 0.035）。这些优势并不以手术时间延长（89.6±28.8 vs. 90.1±30.2 min; p = 0.96）或围手术期并发症为代价。两组的造影剂量相当（172.3±92.7 vs. 197.5±127.8 ml; p = 0.53）。在至少3个月（平均：8.1±5.9个月）的短期随访期间，未发生器械相关事件。超声心动图和荧光透视的自动实时集成可纳入经皮左心耳封堵术的手术工作流程，而不会延长手术时间。这种方法导致辐射暴露的相关减少。ClinicalTrials.gov www.example.com
To investigate whether percutaneous left atrial appendage (LAA) closure guided by automated real-time integration of 2D-/3D-transesophageal echocardiography (TEE) and fluoroscopy imaging results in decreased radiation exposure. In this open-label single-center study LAA closure (AmplatzerTM Cardiac Plug) was performed in 34 consecutive patients (8 women; 73.1±8.5 years) with (n = 17, EN+) or without (n = 17, EN-) integrated echocardiography/fluoroscopy imaging guidance (EchoNavigator® [EN]; Philips Healthcare). There were no significant differences in baseline characteristics between both groups. Successful LAA closure was documented in all patients. Radiation dose was reduced in the EN+ group about 52% (EN+: 48.5±30.7 vs. EN-: 93.9±64.4 Gy/cm2; p = 0.01). Corresponding to the radiation dose fluoroscopy time was reduced (EN+: 16.7±7 vs. EN-: 24.0±11.4 min; p = 0.035). These advantages were not at the cost of increased procedure time (89.6±28.8 vs. 90.1±30.2 min; p = 0.96) or periprocedural complications. Contrast media amount was comparable between both groups (172.3±92.7 vs. 197.5±127.8 ml; p = 0.53). During short-term follow-up of at least 3 months (mean: 8.1±5.9 months) no device-related events occurred. Automated real-time integration of echocardiography and fluoroscopy can be incorporated into procedural work-flow of percutaneous left atrial appendage closure without prolonging procedure time. This approach results in a relevant reduction of radiation exposure. ClinicalTrials.gov NCT01262508