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1、Watchman左心耳封堵器的临床应用姚青1宋治远1,※舒茂琴1郭燕丽2钟理1王文婷2申斌2李华康1柴虹1朱平1刘锋1陈霞11:第三军医大学附属西南医院心内科，重庆市介入治疗研究所2:第三军医大学附属西南医院超声诊断科※:通讯作者摘要：目的：通过应用Watchman左心耳封堵器对非瓣膜病房颤患者左心耳进行封堵治疗，评价左心耳封堵效果与安全性。方法：选择非瓣膜病房颤患者为研究对象，术前行经食道超声心动图（TEE）筛查及CHA2DS2-VASc评分，在全麻下进行操作，分别进行房间隔穿刺术及左心耳造影术，再根据TEE及左心耳造影图像测得的左心耳开口直径
2、与深度选择Watchman左心耳封堵器进行左心耳封堵。术后入住CCU病房，连续监测心电、血压及氧饱和度24小时，并于术后次日及第三天复查经胸超声心动图。结果：11例行左心耳封堵术治疗患者全部成功（成功率100%），其中男6例、女5例，平均年龄65.5±15.3(51～81)岁，平均房颤病史2.65±4.32（0.5～7）年。11例患者CHA2DS2-VASc评分平均3.9±2.1（2～6）分。术中TEE测量左心耳开口最大直径为19.9±2.8mm；左心耳造影图像测得左心耳开口最大直径为20.1±2.8mm；两种方法测量的左心耳开口直径无显著差异（
3、ｐ＞0.05）。所用11枚Watchman封堵器平均直径24.8±4.6mm；植入左心耳内后TEE测量封堵器最大直径平均19.8±5.9mm，压缩率为21.1±4.8%。6例患者封堵后有少量残余分流，无手术相关并发症。结论：应用Watchman左心耳封堵器进行左心耳封堵术安全有效，但预防房颤脑栓塞的远期效果尚需进一步观察随访。关键词：心房颤动，左心耳封堵，Watchman；ClinicalapplicationofleftatrialappendageocclusionbyWatchmanoccluderYaoQing,SongZhi-yuan,
4、ShuMao-qin,GuoYan-li,ZhongLi,WangWen-ting,ShenBin,LiHua-kang,CaiHong,ZhuPing,LiuFeng,ChenXiaDepartmentofCardiologyandDepartmentofDiagnosticUltrasound，SouthwestHospital,ThirdMilitaryMedicalUniversity,InterventionalCardiologyInstituteofChongqing,Chongqing400038,ChinaAbstract:Ob
5、jectiveToinvestigatetheeffectandsafetyofleftatrialappendage(LAA)occlusionwithWatchmanoccludertreatedinnonvalvularfibrillationatrialpatients.MethodsNonvalvularfibrillationatrialpatientswereincludedinthisstudy,andeveryonewasperformedintransesophagealechocardiography(TEE)andCHA2
6、DS2-VAScscoretest.AllthepatientsweregeneralanesthetizedandperformedininteratrialseptumpunctureandLAAangioplasty.ThesizeofWatchmanoccluderwaschoosedfollowingbytheostiumanddepthofLAAmeasuredbyTEEandangioplasty.Aftertheoperation,allthepatientswereinCCUwithelectrocardiogram,blood
7、pressureandoxygensaturationunderobservation.Transthoracicechocardiography(TTE)wasperformedinthedayandthethirddayaftertheoperation.Results11patientswereincludedinthisstudy,6malesand5females,averageyearwas65.5±15.3(51～81)yearsold,andaverageyearofAFwas2.65±4.32(0.5～7)years.Theav
8、erageCHA2DS2-VAScscoreforallpatientswas3.9±2.1(2-6).ThemaximumLAAost
