Comparative Endothelialization of the Watchman Plug Device and LACBES Pacifier Occluder after Left Atrial Appendage Closure.

IF 1.9 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Reviews in cardiovascular medicine Pub Date : 2024-12-23 eCollection Date: 2024-12-01 DOI:10.31083/j.rcm2512450

Jing Zhou, Zongqi Zhang, Kandi Zhang, Tiantian Zhang, Qing He, Junfeng Zhang

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引用次数: 0

Abstract

Background: For patients with nonvalvular atrial fibrillation (NVAF), left atrial appendage closure (LAAC) is an alternative to oral anticoagulants (OACs). However, incomplete device endothelialization (IDE) after LAAC has been linked to device-related thrombus (DRT) and subsequent thromboembolic events. Here, the differences in device endothelialization between the Watchman plug device and the LACBES pacifier occluder after implantation were investigated.

Methods: Of 201 consecutive patients with indications for LAAC, 101 received a Watchman 2.5 device, and 100 received a LACBES occluder. IDE was defined as a residual flow of contrast agent inside the left atrial appendage (LAA) on cardiac computed tomography angiography (CCTA) without peri-device leak (PDL) at the 3-month and 6-month follow-ups.

Results: There were no significant differences in DRT or PDL incidence between the two groups. However, the IDE rate in the absence of PDL was higher in the LACBES group than in the Watchman group at 3 months (42.4% versus 25.8%; p = 0.025) and at the 6-month follow-up (24.7% versus 11.2%; p = 0.028) as determined by CCTA.

Conclusions: Our findings indicated that the LACBES occluder took longer to complete endothelialization than the Watchman device after successful LAAC therapy. CCTA is a reliable imaging method for assessing the sealing of LAAC devices and confirming complete device endothelialization.

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左房附件关闭后Watchman塞器和LACBES安抚器内皮化的比较。

背景：对于非瓣膜性心房颤动（NVAF）患者，左心房附件闭合（LAAC）是口服抗凝剂（OACs）的替代选择。然而，LAAC后不完全器械内皮化（IDE）与器械相关血栓（DRT）和随后的血栓栓塞事件有关。在这里，我们研究了Watchman插头装置和LACBES安抚器闭塞器植入后设备内皮化的差异。方法：在201例具有LAAC适应证的患者中，101例使用Watchman 2.5装置，100例使用LACBES闭塞器。IDE定义为心脏计算机断层血管造影（CCTA）显示造影剂在左心耳（LAA）内的残余血流，随访3个月和6个月时无装置周围泄漏（PDL）。结果：两组患者DRT和PDL发生率无显著差异。然而，在没有PDL的情况下，LACBES组的IDE率在3个月时高于Watchman组(42.4%比25.8%；P = 0.025)和6个月随访时(24.7% vs 11.2%；p = 0.028)。结论：我们的研究结果表明，LAAC治疗成功后，LACBES闭塞器比Watchman装置完成内皮化所需时间更长。CCTA是一种可靠的评估LAAC设备密封性和确认设备完全内皮化的成像方法。

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

Reviews in cardiovascular medicine 医学-心血管系统

CiteScore

2.70

自引率

3.70%

发文量

377

审稿时长

1 months

期刊介绍： RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.