摘要
目的分析经CT左心耳(left atrial appendage,LAA)造影测得LAA参数与LAA封堵术中所选择Watchman封堵器尺寸的相关性。方法收集2016年12月至2019年4月应用Watchman LAA封堵器进行LAA封堵的连续性非瓣膜性房颤患者35例(CHADS2≥1分)。术前CT LAA造影测得LAA参数包括LAA锚定区和LAA解剖口的最大径、最小径、平均直径,以及LAA深度。分析LAA各参数与置入Watchman封堵器型号的相关性。结果35例患者中封堵成功33例(残余分流≤5 mm),失败2例。对最终成功置入封堵器的33例患者的术前影像进行三维数据测量。33例CT测量LAA锚定区最大径、最小径、平均直径及最大深度分别为(27.3±5.1)mm、(20.3±3.9)mm、(23.8±4.1)mm、(22.5±4.3)mm,与置入封堵器大小的相关系数分别为0.711、0.751、0.788、0.407(P<0.05);LAA解剖口的最大径、最小径及平均直径分别为(34±4.3)mm、(22.5±4.6)mm、(28.3±4.1)mm,与置入封堵器大小的相关系数分别为0.628、0.493、0.602(P<0.05)。结论经CT左心耳造影测得的LAA锚定区平均直径与Watchman LAA封堵器型号的相关性最好,可能最有助于选择合适的封堵器型号。
Objective To analyze the correlation between left atrial appendage(LAA)parameters measured by CT LAA angiography and the size of Watchman occluder selected in LAA occlusion.Methods Consecutive 35 atrial fibrillation patients(CHADS2≥1)underwent LAA occlusion between December 2016 and April 2019.LAA parameters including the maximum diameter,minimum diameter and mean diameter of the LAA anchoring zone and LAA anatomy zone,and LAA depth of the LAA anchoring zone were measured by preoperative CT angiography.The correlation between the LAA parameters and the size of the LAA Watchman occlude were analzyed.Results Among the 35 patients,33 were successfully blocked(peripheral leakage≤5 mm),and 2 failed.The maximum,minimum and average diameters of LAA and LAA depth of the anchoring zone were(27.3±5.1)mm,(20.3±3.9)mm,(23.8±4.1)mm,(22.5±4.3)mm,and their coefficient of correlation were 0.711,0.751,0.788 and 0.407 with Watchman device size(P<0.05).The maximum,minimum and average diameters of LAA anatomical orifice were(34±4.3)mm,(22.5±4.6)mm,and(28.3±4.1)mm,and their coefficient of correlation were 0.628,0.493 and 0.602(P<0.05)with Watchman model diameter.Conclusion In LAA CT angiography,the average diameter of anchoring area has the best correlation with Watchman device size,which may be the most helpful parameter for the selection of suitable occluder.
作者
王翔
侯志辉
安云强
于易通
张浩
李珈含
吕滨
WANG Xiang;HOU Zhi-hui;AN Yun-qiang;YU Yi-tong;ZHANG Hao;LI Jia-han;LV Bin(Department of Radiology,Fuwai Hospital,Chinese Academy of Medical Sciences,Peking Union Medical College,Beijing 100037;Department of Cardiology,Chongqing General Hospital,Chongqing 400013;The First Mobile Corps of People's Armed Police,Beijing 101100,China)
出处
《中国分子心脏病学杂志》
CAS
2019年第5期3039-3043,共5页
Molecular Cardiology of China
关键词
CT左心耳造影
左心耳
封堵
Watchman封堵器
CT left atrial appendage angiography
Left atrial appendage
Occlusion
Watchman occluder
