Left atrial appendage occlusion device causing coronary obstruction: A word of caution

Kuzmin Boris; Staack Thorsten; Wippermann Jens; Wacker Max

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Left atrial appendage occlusion device causing coronary obstruction: A word of caution

机译：左心房阑尾闭塞装置导致冠状动脉梗阻：小心一词

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摘要

Closure of the left atrial appendage is a common procedure for patients with atrial fibrillation undergoing cardiac surgery. The technique of left atrial appendage occlusion (LAAO) by an extracardiac clip (AtriClip) is established as a reliable method. Acute coronary obstruction of the circumflex artery has already been described after minimally invasive LAAO. Here, we report a case of delayed circumflex artery obstruction after open-heart surgery. A patient who had mitral and tricuspid valve surgery in combination with AtriClip implantation suffered from myocardial infarction 24 h after clip implantation. Cardiac catheterization showed that the circumflex artery was obstructed on the level of the AtriClip device. The stenosis was treated by percutaneous coronary intervention with stent implantation. In conclusion, the surgeon should consider placing the AtriClip device slightly far away from the base of the left atrial appendage to avoid coronary obstruction.

机译：关闭左心耳是接受心脏手术的心房颤动患者的常见手术。心外膜夹（AtriClip）封堵左心耳（LAAO）技术是一种可靠的方法。微创LAAO术后已出现回旋动脉急性冠状动脉阻塞。在此，我们报告一例心脏直视手术后延迟性回旋动脉阻塞的病例。一位接受二尖瓣和三尖瓣手术联合心房夹植入术的患者在心房夹植入术后24小时发生心肌梗死。心导管插入术显示，在心房夹装置的水平上，回旋动脉被阻塞。狭窄采用经皮冠状动脉介入治疗加支架植入术。综上所述，外科医生应考虑将Aut李唇装置放置在远离左心耳的基础上，以避免冠状动脉阻塞。

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来源
《Journal of cardiac surgery.》 |2021年第2期|共3页
作者
Kuzmin Boris; Staack Thorsten; Wippermann Jens; Wacker Max;
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作者单位

Otto Von Guericke Univ Dept Cardiothorac Surg Magdeburg Germany;

Otto Von Guericke Univ Dept Cardiothorac Surg Magdeburg Germany;

Otto Von Guericke Univ Dept Cardiothorac Surg Magdeburg Germany;

Otto Von Guericke Univ Dept Cardiothorac Surg Magdeburg Germany;

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正文语种 eng
中图分类心脏血管和淋巴系外科学;
关键词
cardiac complications; coronary artery stenosis; left atrial appendage occlusion; NSTEMI;

机译：心脏并发症;冠状动脉狭窄;左心房阑尾闭塞;nstemi;

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1. Device-related thrombosis on atrial septal defect occluder after simultaneous closure of left atrial appendage and atrial septal defect: a case report [J] . Lu HE, Ya-Juan DU, Ge-Sheng CHENG, 老年心脏病学杂志（英文版） . 2019,第006期
2. Surgical left atrial appendage occlusion in patients with atrial fibrillation undergoing mechanical heart valve replacement [J] . Ye Zheng, Chen-Fei Rao, Si-Peng Chen, 中华医学杂志（英文版） . 2020,第016期
3. Incomplete occlusion of the left atrial appendage with the percutaneous left atrial appendage transcatheter occlusion device is not associated with increased risk of stroke [J] . Juan F. Viles-Gonzalez, Vivek Y. Reddy, Jan Petru, Journal of Interventional Cardiac Electrophysiology . 2012,第1期

机译：经皮左心耳经导管闭塞装置不完全阻塞左心耳与卒中风险增加无关
4. Incomplete occlusion of the left atrial appendage with the percutaneous left atrial appendage transcatheter occlusion device is not associated with increased risk of stroke. [J] . Juan F Viles-Gonzalez, Vivek Y Reddy, Jan Petru, Journal of interventional cardiac electrophysiology: an international journal of arrhythmias and pacing . 2012,第1期

机译：经皮左心耳经导管阻塞装置不完全阻塞左心耳与卒中风险增加无关。
5. Device enabled left atrial appendage ligation-A word of caution Reply [J] . Afzal Muhammad R., Lee Randall, Lakkireddy Dhanunjaya Heart rhythm: the official journal of the Heart Rhythm Society . 2016,第10期

机译：装置启用左心耳结扎-注意事项回复
6. Simulation of the Hemodynamic Effects of the Left Atrial Appendage Occlusion in Atrial Fibrillation: Preliminary Results [C] . Nadia DAlessandro, Alessandro Masci, Alice Andalò, Computing in Cardiology . 2020

机译：左心房阑尾闭塞在心房颤动中的血流动力学效应的模拟：初步结果
7. Optimal Post-Procedural Therapy for Patients Ineligble for Treatment with Oral Anticoagulatiion Who Undergo Left Atrial Appendage Occlusion with the Watchman Device for Non-Valvular Atrial Fibrillation [D] . Whitehead, Kristen Marie. 2020

机译：用口腔抗凝血治疗患者患者的最佳过程治疗患者患有左心房阑尾闭塞与鹰刀用于非瓣膜心房颤动
8. Left atrial appendage morphology echocardiographic characterization procedural data and in-hospital outcome of patients receiving left atrial appendage occlusion device implantation: a prospective observational study [O] . Christian Fastner, Michael Behnes, Benjamin Sartorius, 2016

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Left atrial appendage occlusion device causing coronary obstruction: A word of caution

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