Minimalistic approach to left atrial appendage occlusion gu-ided by cardiac computed tomography angiography
Xian-Sai MENG1
Qing-Song WANG1
Xin-Yan WANG1
Xu LU1
Yang MU2
Jing WANG2
Ting-Ting SONG2
Yun-Dai CHEN2
Tao CHEN2
Jun GUO2
1.Graduate School of Chinese PLA Medical College,Beijing,China2.Senior Department of Cardiology,the Sixth Med-ical Center,Chinese PLA General Hospital,Beijing,China
摘要：OBJECTIVE To assess the feasibility and safety of the minimalistic approach to left atrial appendage occlusion(LAAO)guided by cardiac computed tomography angiography(CCTA).
METHODS Ninety consecutive patients who underwent LAAO,with or without CCTA-guided,were matched(1:2).Each step of the LAAO procedure in the computed tomography(CT)guidance group(CT group)was directed by preprocedural CT plan-ning.In the control group,LAAO was performed using the standard method.All patients were followed up for 12 months,and device surveillance was conducted using CCTA.
RESULTS A total of 90 patients were included in the analysis,with 30 patients in the CT group and 60 matched patients in the control group.All patients were successfully implanted with Watchman devices.The mean ages for the CT group and the control group were 70.0±9.4 years and 68.4±11.9 years(P=0.52),respectively.The procedure duration(45.6±10.7 min vs.58.8±13.0 min,P＜0.001)and hospital stay(7.5±2.4 day vs.9.6±2.8 day,P=0.001)in the CT group was significantly shorter compared to the co-ntrol group.However,the total radiation dose was higher in the CT group compared to the control group(904.9±348.0 mGy vs.711.9±211.2 mGy,P=0.002).There were no significant differences in periprocedural pericardial effusion(3.3%vs.6.3%,P=0.8)be-tween the two groups.The rate of postprocedural adverse events(13.3%vs.18.3%,P=0.55)were comparable between both grou-ps at 12 months follow-up.
CONCLUSIONS CCTA is capable of detailed LAAO procedure planning.Minimalistic LAAO with preprocedural CCTA plan-ning was feasible and safe,with shortened procedure time and acceptable increased radiation and contras consumption.For pat-ients with contraindications to general anesthesia and/or transesophageal echocardiography,this promising method may be an alternative to conventional LAAO.
机标关键词：angiographytomographycomputedappendageapproachatrialcardiacgu-ided
论文发表日期：2024-04-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：12( 431-442 )