The preliminary experience of modified percutaneous left atrial appendage occlusion under transthoracic echocardiographic guidance without general anesthesia / 中国介入心脏病学杂志

Objective To investigate the feasibility and safety of modified percutaneous left atrial appendage occlusion (PLAAO) under transthoracic echocardiographic (TTE) guidance without general anesthesia instead of transesophageal echocardiographic guidance.Methods A total of 14 patients who met the inclusion criteria underwent modified PLAAO guided by TTE instead of TEE without general anesthesia.Regular clinical follow-up observations of PLAAO-related major adverse events were done in the perioperative period.Results All patients were successfully implanted with left atrial appendage occluder device (Watchman) without device-related serious complications.Immediately occlusion success rate was 100％.No major adverse events occurred during hospitalization and follow-up.The mean operation time was 108 ± 22 min(range 75-150 min)and the mean radiation exposure time was 15.8 ± 7.6 min(range 8-32 min).Conclusion Modified PLAAO guided by TTE instead of TEE without general anesthesia may be safe and effective.This method simplifies the operation process and is favorable for PLAAO application.But this modified PLAAO is still needed to be validated in more patients.

Progress in clinical research of left atrial appendage occluder / 介入放射学杂志

Atrial fibrillation (AF) is a common kind of arrhythmia,it is one of the main reasons causing ischemic stroke in aged patients.Left atrial appendage is the primary site where the thrombus is formed in non-valvular atrial fibrillation (NVAF) patients.Recent researches have indicated that occlusion of left atrial appendage can effectively reduce the occurrence of ischemic stroke in NVAF patients,its curative effect is no less than the preventive treatment effect of warfarin.The use of an ideal left atrial appendage occluder is the key to ensure a successful occlusion of the left atrial appendage.After decades of research,several left atrial appendage occluders have been developed,among them Watchman occluder and Amplatzer cardiac plug (ACP) are commonly used nowadays in clinical practice,and some kinds of occluder are still at their experimental research stage.This article aims to make a brief introduction about the current status of the study and the clinical application of left atrial appendage occluder.(J Intervent Radiol,2017,26:281-284)