目的 初步探究一种新型国产左心耳封堵器(LAMaxTM plus)经皮封堵犬双叶宽开口左心耳的可行性及即刻有效性。方法 选取3只双叶型宽开口左心耳健康犬使用LAMaxTM plus封堵器行经皮左心耳封堵术，术后即刻复查左心耳造影及经食管超声心动图评价封堵效果，以彩色多普勒超声观测无残余分流或残余分流直径<3 mm为封堵成功。结果 3只犬中1例使用单叶型封堵器封堵不全，更换为双叶封堵器后封堵成功;其余2例均一次封堵成功，且均未见新发二尖瓣反流，封堵器未影响肺静脉开口，无心包穿孔等手术或器械相关的并发症。结论 本研究初步证实了LAMaxTMplus左心耳封堵器用于封堵犬双叶左心耳的可行性和即刻有效性。目前LAMaxTMplus封堵器后续动物试验正在进行中，关于其安全性和有效性进一步研究结果值得期待。
Abstract
Objective To demonstrate the feasibility and effectiveness of a left atrial appendage (LAA) occluder (LAMaxTM plus,Keyidun,China) for the instant occlusion of LAA in canine model, which is specially designed for the occlusion of LAA with two lobes and a wider orifice.Methods Three healthy dogs were used for the implantation of LAMaxTM plus devices, which can be fully recaptured and repositioned during implantation procedure. Before the implantation, transthoracic echocardiography (TTE) was performed for anatomical evaluation of LAA with two lobes and then transesophageal echocardiography (TEE) followed by angiography. The devices were delivered by 9F or 10F delivery sheathes. The angiography of LAA was performed immediately after the implantation and then TEE examination followed to evaluate the device position, leakage around the device, pericardial effusion, mitral valve function, and pulmonary vein obstruction. The effectiveness of LAA occlusion was assessed by an endpoint of leak around the device less than 3mm of flow by TEE.Results The LAMaxTM plus was successfully implanted in all three dogs. By observation of the post-implant TEE, all dogs reached the defined endpoint for the effectiveness of LAA occlusion.Conclusions This preliminary study confirms that LAMaxTM plus device is feasible and effective for the instant occlusion of LAA with two lobes in canines. More studies are needed before it can be used in clinical applications.
关键词
心房颤动 /
卒中 /
左心耳封堵 /
LAMax /
动物实验
Key words
atrial fibrillation /
stroke /
left atrial appendage closure /
LAmax /
animal experimentation
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参考文献
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基金
深圳市科技创新委员会创业资助项目(深发改【2015】1342号)
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