Combining echocardiography and fluoroscopy imaging in real time for left atrial appendage occlusion - single center experience from Poland.

IF 0.6 Q4 SURGERY
Kardiochirurgia I Torakochirurgia Polska Pub Date : 2024-03-01 Epub Date: 2024-03-30 DOI:10.5114/kitp.2024.138575
Marian Burysz, Jakub Batko, Michalina Helena Malec-Litwinowicz, Mariusz Kowalewski, Radosław Adam Litwinowicz, Aleksandra Burysz, Łukasz Graczykowski, Wojciech Olejek
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引用次数: 0

Abstract

Introduction: Atrial fibrillation (AF) presents a growing health concern, often requiring stroke prevention measures, primarily through oral anticoagulation (OAC). Surgical interventions such as left atrial appendage occlusion (LAAO) offer alternatives when OAC is contraindicated. In recent years, percutaneous procedures have gained traction as minimally invasive options, demanding precise anatomical insights. Fusion imaging (FI), which combines transesophageal echocardiography (TEE) and fluoroscopy, has emerged as a potential game-changer in transcatheter interventions.

Aim: This study introduces FI to LAAO procedures in Poland, assessing its role in guiding interventions, highlighting advantages, and exploring its potential to reshape cardiovascular interventions.

Material and methods: We conducted a retrospective study involving LAAO procedures from March 2015 to December 2018, all utilizing FI. Patient indications, procedural specifics, and safety metrics were collected and analyzed. Follow-ups were conducted at 3 and 6 months.

Results: A cohort of 83 patients (mean age: 72.1 ±8.4 years) underwent successful LAAO procedures. FI provided precise device placement and anatomical assessment. Mean procedure time was 54.9 ±34.3 min, contrast medium usage averaged 33.7 ±22.7 ml, and creatinine levels remained stable. Patients were discharged in about 4.2 ±3.4 days. Adverse effects were rare, including minimal bleeding and cardiac tamponade. Follow-ups demonstrated favorable outcomes with low adverse event rates.

Conclusions: This study marks the inaugural application of FI in Polish LAAO procedures. FI, offering enhanced visualization and reduced procedure times, holds promise in improving patient safety and treatment efficacy. We recommend its consideration as a standard visualization technique for LAAO procedures.

实时结合超声心动图和透视成像检查左房阑尾闭塞--波兰单中心的经验。
导言:心房颤动(房颤)是一个日益令人担忧的健康问题,通常需要采取预防中风的措施,主要是通过口服抗凝药(OAC)。在禁用口服抗凝药的情况下,左心房阑尾封堵术(LAAO)等外科干预措施提供了替代方案。近年来,经皮手术作为一种微创选择受到越来越多的关注,但需要精确的解剖洞察力。融合成像(FI)结合了经食道超声心动图(TEE)和透视技术,已成为经导管介入治疗领域潜在的游戏规则改变者:我们进行了一项回顾性研究,涉及 2015 年 3 月至 2018 年 12 月期间的 LAAO 手术,所有手术均使用了 FI。我们收集并分析了患者适应症、手术细节和安全性指标。在 3 个月和 6 个月时进行随访:83名患者(平均年龄:72.1±8.4岁)成功接受了LAAO手术。FI 提供了精确的装置置放和解剖评估。平均手术时间为(54.9±34.3)分钟,造影剂用量平均为(33.7±22.7)毫升,肌酐水平保持稳定。患者约在 4.2 ± 3.4 天后出院。不良反应极少,包括少量出血和心脏填塞。随访结果显示,患者的预后良好,不良事件发生率较低:这项研究标志着 FI 在波兰 LAAO 手术中的首次应用。FI 可增强可视性并缩短手术时间,有望提高患者安全性和治疗效果。我们建议将其作为 LAAO 手术的标准可视化技术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
0.90
自引率
14.30%
发文量
44
审稿时长
6-12 weeks
期刊介绍: Polish Journal of Thoracic and Cardiovascular Surgery is a quarterly aimed at cardiologists, cardiosurgeons and thoracic surgeons. Includes the original works (experimental, research and development), illustrative and casuistical works about cardiology and cardiosurgery.
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