左心耳封堵术之Watchman装置.pdfVIP

2015年12月第35卷第12期 中国实用内科杂志 991 专题笔谈·左心耳封堵临床实践 左心耳封堵术之Watchman装置 侯东明，Akinapelli A，Alex P，Nicole G，Kenneth S，Barbara H DOI：10.7504/nk2015110203 中图分类号：R541.7 文献标识码：A 摘要 ：心房颤动 ( 简称房颤 ) 是临床疾病诊治过程中最常遇见的一种快速性心律失常。非瓣膜性房颤患者脑卒中的 发病风险增加约 5 倍，随着年龄的增长这一风险呈指数性增长。心源性脑栓塞明显增加患者死亡风险。左心耳是非 瓣膜性房颤患者血栓形成的主要部位。Watchman (Boston Scientific, MA) 是一种经皮左心耳封堵器 (LAAC)，其疗效 已经被多个前瞻性随机研究所验证。对于那些栓塞风险高的非瓣膜性房颤患者，为了寻找长期华法林替代治疗方 法以降低新发脑卒中风险的另一选择。基于大量有关 Watchman 的临床研究项目，包括超过 2000 个患者及近 6000 个病人·年随访的众多研究结果，Watchman LAAC 成为目前惟一获得美国 FDA 批准的左心耳封堵器。 关键词 ：房颤 ；左心耳封堵 ；Watchman Left atrial appendage closure – the Watchman device HOU Dong ming, Akinapelli A, Alex P, Nicole G, Kenneth S, Barbara H. . - Creighton University Medical Center, Omaha, NE, USA Corresponding author: HOU Dong-ming , E-mail:Dongminghou001@ Abstract: Atrial fibrillation (AF) is one of the most common rapid arrhythmias seen in clinical cardiology. Patients with non-valvular AF have an approximately 5-fold increase in the risk of stroke, with an exponential increase with advancing ages. Cardioembolic strokes carry a high mortality risk. The left atrial appendage is the major source of thrombus formation in patients with non-valvular AF. The Watchman (Boston Scientific, MA) is a percutaneous left atrial appendage closure (LAAC) device which has been tested prospectively in multiple randomized trials. It offers a new stroke risk reduction option for high-risk patients with non-valvular atrial fibrillation who are seeking an alternative to long-term warfarin therapy. Based on the robust Watchman clinical program which consists of numerous studies, with more than 2000 patients and nearly 6000 patient-years of follow-up