Impact of Angiographically Detected Residual Trabeculation After Left Atrial Appendage Closure Using the WATCHMAN Device: Insight From the OCEAN-LAAC Registry.
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引用次数: 0
Abstract
Background: Research on the impact of angiographically detected residual trabeculation after left atrial appendage closure (LAAC) is limited.
Objectives: To investigate the incidence, characteristics, and clinical implications of angiographically detected residual trabeculation after LAAC using the WATCHMAN device.
Methods: We analyzed 1350 consecutive patients with atrial fibrillation undergoing LAAC using the WATCHMAN device from the OCEAN-LAAC registry, which is a prospective ongoing, multicenter Japanese registry. The inclusion criteria comprised patients who successfully underwent LAAC and whose presence or absence of residual trabeculation can be confirmed using a contrast medium. The clinical outcomes were compared between patients with and without angiographically detected residual trabeculation.
Results: Residual trabeculation was angiographically detected in 5.6% (75/1350 patients). At the procedure, the proportion of peri-device leak (PDL) was significantly higher in the residual trabeculation group than in the non-residual trabeculation group (20% vs. 5.1%, p < 0.001). However, the PDL and device-related thrombosis at 45 days and 1 year were comparable between the two groups (37% vs. 23%, p = 0.24; 28% vs. 31%, p = 0.84; 2.1% vs. 1.4%, p = 0.50; 6.9% vs. 6.0%, p = 0.69, respectively). The 3-year cumulative incidence of ischemic stroke, all cardiovascular death, and all-cause death were comparable between the two groups (5.7% vs. 5.5%, log-rank p = 0.96; 7.7% vs. 8.9%, log-rank p = 0.34, 31.4% vs. 22.3%, log-rank p = 0.71, respectively).
Conclusion: The angiographically detected residual trabeculation rate was 5.6%, and this population had a significantly higher prevalence of PDL at the procedure. However, the presence of residual trabeculation did not contribute to PDL or device-related thrombosis at follow-up or affect the clinical outcomes.
背景：关于左心房附件关闭（LAAC）后血管造影检测残余小梁影响的研究有限。目的：探讨使用WATCHMAN装置LAAC后血管造影检测到残余小梁的发生率、特点和临床意义。方法：我们分析了1350例连续的房颤患者，使用来自OCEAN-LAAC注册中心的WATCHMAN装置进行LAAC，这是一个前瞻性的、持续的、多中心的日本注册中心。纳入标准包括成功行LAAC的患者，其残余小梁的存在或不存在可以用造影剂确认。比较有和没有血管造影检测到残余小梁的患者的临床结果。结果：5.6%（75/1350）患者在血管造影检查中发现残余小梁。在手术过程中，残余小梁组的设备周围泄漏（PDL）比例明显高于非残余小梁组(20% vs. 5.1%， p结论：血管造影检测到残余小梁率为5.6%，该人群在手术过程中PDL的患病率明显高于非残余小梁组（20% vs. 5.1%）。然而，在随访中，残余小梁的存在并没有导致PDL或器械相关血栓形成，也没有影响临床结果。
期刊介绍：
Journal of Cardiovascular Electrophysiology (JCE) keeps its readership well informed of the latest developments in the study and management of arrhythmic disorders. Edited by Bradley P. Knight, M.D., and a distinguished international editorial board, JCE is the leading journal devoted to the study of the electrophysiology of the heart.
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