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首页> 美国卫生研究院文献>Cardiology Journal >Pulmonary artery and left atrial appendage anatomical relationship using electrocardiogram-gated computed tomography: An important aspect of left atrial appendage occlusion
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Pulmonary artery and left atrial appendage anatomical relationship using electrocardiogram-gated computed tomography: An important aspect of left atrial appendage occlusion

机译：肺动脉和左心房阑尾解剖学关系使用心电图门计算断层扫描：左心房附属闭塞的一个重要方面

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Atrial fibrillation (AF) is an important cause of morbidity and mortality worldwide. The Framingham study and other studies have demonstrated a fivefold increase in overall stroke risk associated with AF [1]. Vitamin K antagonists have been shown to reduce stroke or systemic thromboembolism by 64% and all-cause mortality by 26%. The newer non-vitamin K antagonist oral anticoagulants give an additional reduction effect with better adherence observed. Unfortunately, chronic anticoagulation is associated with a significant risk of major bleeding. Patients who have contraindications to anticoagulant treatment may derive benefit from left atrial appendage (LAA) occlusion. Transcatheter LAA closure has emerged as a potential alternative to oral anticoagulation in AF patients and contraindications for long-term oral anticoagulation. In recent years, it has been reported in the literature a few cases of pulmonary artery (PA) wall perforation leading to cardiac tamponade and even death following by an appendage closure using Amplatzer Cardiac Plug (ACP) or Amplatzer Amulet Occluder (AAO) [2, 3]. One of those reports revealed a close anatomical relationship between LAA and PA as the most likely explanation for this complication, based on the preprocedural cardiac computed tomography (CT) examination [4]. The aim of the present study was to assess the anatomical relationship and the distance between LAA and PA by means of electrocardiogram (ECG)-gated CT.
机译：心房颤动（AF）是发病率和死亡率世界范围内的一个重要原因。 Framingham研究和其他研究已经证实有AF [1]关联的整体中风的风险增加了五倍。维生素K拮抗剂已显示出了26％，以减少64％中风或全身性血栓栓塞和所有原因的死亡率。较新的非维生素K拮抗剂口服抗凝血剂得到具有观察到更好地粘附需额外降低效果。不幸的是，慢性抗凝治疗与大出血的显著风险。谁拥有禁忌抗凝治疗的患者可能获得左心耳（LAA）闭塞的好处。经导管左心耳封闭已成为一个潜在的替代房颤患者和禁忌口服抗凝药长期口服抗凝药。近年来，已文献报道肺动脉（PA）壁穿孔，导致心包填塞，甚至死亡通过封堵心脏插头（ACP）或封堵护身符封堵器（AAO）[2附属物关闭后，有少数病例，3]。其中的一个报告显示LAA和PA之间作为这种并发症的最可能的解释密切解剖关系的基础上，preprocedural心脏计算机断层扫描（CT）检查[4]。本研究的目的是评估解剖关系和通过心电图的装置（ECG）门控CT LAA和PA之间的距离。

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