"One-stop" left atrial appendage clipping combined with transcatheter aortic valve replacement for patients with atrial fibrillation and aortic valve disease
- VernacularTitle:“一站式”左心耳夹闭术联合经导管主动脉瓣置换术治疗主动脉瓣病变合并心房颤动
- Author:
Zhaolei JIANG
1
;
Ju MEI
1
;
Min TANG
1
;
Jianbing HUANG
1
;
Fangbao DING
1
;
Hao LIU
1
;
Sai’e SHEN
2
Author Information
1. Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, P. R. China
2. Department of Anesthesiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, P. R. China
- Publication Type:Journal Article
- Keywords:
"One-stop";
left atrial appendage clipping;
transcatheter aortic valve replacement;
atrial fibrillation
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2022;29(05):560-564
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the experience and efficacy of "one-stop" left atrial appendage clipping (LAAC) combined with transcatheter aortic valve replacement (TAVR) for patients with atrial fibrillation (AF) and aortic valve disease. Methods From April 2018 to March 2021, 16 patients with AF and severe aortic valve disease underwent "one-stop" LAAC and TAVR in our department. All patients had long-standing persistent AF. There were 10 males and 6 females with an average age of 77.2±6.2 years. CHA2DS2-VASc score was 4.4±0.8 points, and HAS-BLED score was 3.5±0.7 points. Results All patients successfully underwent "one-stop" LAAC combined with TAVR. There was no death during perioperative and follow-up periods. The length of the left atrial appendage base measured during the operation was 37.8±3.5 mm. The types of atrial appendage clip were 35 mm (n=3), 40 mm (n=8) and 45 mm (n=5). The time required for clipping the left atrial appendage (from skin cutting to skin suturing) was 25.7±3.8 min. There was no stroke or bleeding of important organs during the perioperative period. The average hospital stay was 6.8±2.0 d. The follow-up time was 19.6±10.1 months, during which there was no patient of cerebral hemorrhage or cerebral infarction. During the administration of warfarin, 2 patients had subcutaneous ecchymosis and 1 patient had gingival bleeding. Conclusion "One-stop" LAAC combined with TAVR can be safely and effectively used to treat AF and aortic valve disease patients with high risk of thromboembolism and anticoagulant bleeding. The early and middle-term curative effect is satisfactory.
