Single Fluoroscopy Versus Transesophageal Echocardiogram: A Comparative Evaluation for Left Atrial Appendage Occlusion With LACbes Device

IF 3.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Therapeutics Pub Date : 2025-10-12 DOI:10.1155/cdr/9933780

Mingfei Li, Dawei Lin, Lei Zhang, Jianing Fan, Wenzhi Pan, Xiaochun Zhang, Daxin Zhou, Junbo Ge

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引用次数: 0

Abstract

Objectives

This study was aimed at evaluating the effectiveness of fluoroscopy as an intraprocedural guidance method during left atrial appendage occlusion (LAAO) using the LACbes device.

Methods

The study included a cohort of 477 patients with nonvalvular atrial fibrillation (AF) who underwent LAAO. The cohort was divided into two groups: a retrospective group of 240 patients who underwent standard procedures involving both transesophageal echocardiogram (TEE) and fluoroscopy and a prospective group of 237 patients who only underwent fluoroscopy. The retrospective cohort was analyzed for device positioning, anchoring, compression, and peridevice leak (PDL) using both TEE and fluoroscopy to provide detailed insights for potential application in the prospective cohort. Clinical outcomes were compared between the two groups.

Results

There were no significant differences in left atrial appendage (LAA) characteristics and other echocardiographic parameters between the two groups. Although the prospective group had a higher prevalence of implantation failure and more deployment attempts per procedure, these differences did not reach statistical significance. Notable differences were observed in fluoroscopy and operation times. Specifically, the prospective group had longer fluoroscopy times and more deployment attempts per procedure but shorter overall operation times compared to the retrospective group. Additionally, patients in the prospective group had shorter hospital stays and lower hospitalization costs. Periprocedural and 2-year follow-up complications were comparable between both cohorts, with no statistically significant differences observed in pericardial effusion, peripheral vascular complications, survival, cardiac death, PDL, or device thrombus.

Conclusions

The use of fluoroscopy as the sole guidance modality for LAAO with the LACbes device demonstrated promising results in terms of efficacy and safety. It emerges as a viable and cost-effective alternative, offering a more efficient approach for LAAO.

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单透视与经食管超声心动图：LACbes装置对左心耳闭塞的比较评价

目的本研究旨在评估使用LACbes装置的左心耳闭塞术中透视作为术中指导方法的有效性。方法本研究纳入477例接受LAAO治疗的非瓣膜性心房颤动（AF）患者。该队列被分为两组：回顾性组240名患者接受了包括经食管超声心动图（TEE）和透视检查在内的标准程序，前瞻性组237名患者只接受了透视检查。回顾性队列分析器械定位、锚定、压缩和器械周围泄漏（PDL），使用TEE和透视，为前瞻性队列的潜在应用提供详细的见解。比较两组患者的临床结果。结果两组患者左心耳（LAA）特征及其他超声心动图参数差异无统计学意义。虽然前瞻性组有更高的植入失败率和每次手术更多的部署尝试，但这些差异没有达到统计学意义。在透视和手术时间上观察到显著差异。具体来说，与回顾性组相比，前瞻性组每次手术有更长的透视时间和更多的部署尝试，但总手术时间更短。此外，前瞻性组患者住院时间较短，住院费用较低。围手术期和2年随访并发症在两个队列之间具有可比性，在心包积液、周围血管并发症、生存率、心源性死亡、PDL或装置血栓方面没有统计学上的显著差异。结论使用透视作为LAAO的唯一指导方式，结合LACbes装置在疗效和安全性方面具有良好的效果。它是一种可行的、具有成本效益的替代方案，为LAAO提供了一种更有效的方法。

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

Cardiovascular Therapeutics 医学-心血管系统

CiteScore

5.60

自引率

0.00%

发文量

审稿时长

6 months

期刊介绍： Cardiovascular Therapeutics (formerly Cardiovascular Drug Reviews) is a peer-reviewed, Open Access journal that publishes original research and review articles focusing on cardiovascular and clinical pharmacology, as well as clinical trials of new cardiovascular therapies. Articles on translational research, pharmacogenomics and personalized medicine, device, gene and cell therapies, and pharmacoepidemiology are also encouraged. Subject areas include (but are by no means limited to): Acute coronary syndrome Arrhythmias Atherosclerosis Basic cardiac electrophysiology Cardiac catheterization Cardiac remodeling Coagulation and thrombosis Diabetic cardiovascular disease Heart failure (systolic HF, HFrEF, diastolic HF, HFpEF) Hyperlipidemia Hypertension Ischemic heart disease Vascular biology Ventricular assist devices Molecular cardio-biology Myocardial regeneration Lipoprotein metabolism Radial artery access Percutaneous coronary intervention Transcatheter aortic and mitral valve replacement.