- 作者：José ; R. Ló ; pez-Mí ; nguez ; lopez-minguez@hotmail.com ; Javier Eldoayen-Gragera ; Reyes Gonzá ; lez-Ferná ; ndez ; Concepció ; n Ferná ; ndez-Vegas ; Marí ; a E. Fuentes-Cañ ; amero ; Victoria Millá ; n-Nuñ ; ez ; Juan M. Nogales-Asensio ; Ana Martí ; nez-Naharro ; Sara Sá ; nchez-Giralt ; Manuel Doblado-Calatrava ; Antonio Merchá ; n-Herrera
- 关键词：AAI ; apé ; ndice auricular izquierdo ; ACO ; anticoagulantes orales ; ACP ; Amplatzer Cardiac Plug o tapó ; n cardiaco Amplatzer ; FA ; fibrilació ; n auricular ; RM ; resonancia magné ; tica ; TC ; tomografí ; a computarizada
- 刊名：Revista Espa?ola de Cardiolog¡§aa
- 出版年：2013
- 出版时间：February, 2013
- 年：2013
- 卷：66
- 期：2
- 页码：90-97
- 全文大小：773 K
Introduction and objectives
Left atrial appendage closure?can be an attractive option for patients with nonvalvular atrial fibrillation and a contraindication to oral anticoagulants, provided that satisfactory results can be achieved during implantation and follow-up.
Methods
Thirty-five consecutive patients, not eligible for randomized trials with oral anticoagulants, had an Amplatzer occlusion device implanted under general anesthesia. After the first 5 patients, 3-dimensional imaging was incorporated. The results of the implantation and the follow-up were analyzed over a 1-year period.
Results
The mean age was 74.65 (7.61) years, with a CHADS2 score of 2.41 (1.53) and a CHA2DS2-VASc score of 3.17 (1.60). Implantation failed in 1 patient and 5 needed a change in the selected plug size. There were no cardiac complications during the implantation or hospital stay. There was 1 vascular complication (arteriovenous fistula). Transesophageal echocardiography monitoring was performed at 24 h, 1, 3, 6 and 12 months and we found 5 thrombi which were resolved with heparin. In the follow-up period of 21.14 (10.09) months, 3 patients aged>80 years died, none of them due to heart problems, and one transient ischemic stroke without further consequences.
Conclusions
Left atrial appendage closure?by an experienced operator can be a treatment option with few complications and with efficient results at>1 year in reducing thromboembolic and hemorrhagic complications, even in very high-risk groups.