夏林莺,刘毅,陶凌

• 1:空军军医大学西京医院心脏内科
• 2:西安交通大学第二附属医院心内科

摘要(Abstract)：

目的对目前国内外Watchman封堵器置入术后器械相关血栓(DRT)事件发生率及临床转归进行Meta分析。方法利用PubMed、EMbase、中国知网和万方数据库检索1999年12月至2018年12月发表的关于Watchman封堵术后器械相关血栓的国内外研究文献,并按照纳入排除标准对所收集文献进行筛选、资料提取及质量评价后,采用Stata软件进行系统评价。结果经筛选共纳入11篇文献(11项研究,共计4664例患者)。Meta分析结果显示,Watchman封堵术后器械相关血栓发生率为3.0%(95%CI 2%～4%),Watchman封堵器置入术后DRT组患者发生缺血性卒中/短暂性脑缺血发作(TIA)的危险度为3.57(95%CI 2.13～6.00)。结论 Watchman封堵术后DRT发生率为3.0%,Watchman封堵术后DRT的发生,增加3.57倍的缺血性卒中/TIA风险。

关键词(KeyWords)： 左心耳封堵术;Watchman封堵器;器械相关血栓;Meta分析

Abstract:

Keywords:

基金项目(Foundation): 西京医院临床高新技术项目(XJGX15Y52)

作者(Author): 夏林莺,刘毅,陶凌

参考文献(References)：

• [1] Berger RD. Watchman device-related thrombus:defeating the purpose of the device? JACC Clin Electrophysiol, 2017,3(12):1387-1389.
• [2] Lempereur M, Aminian A, Freixa X, et al. Device-associated thrombus formation af ter lef t atrial appendage occlusion:A systematic review of events reported with the Watchman, the Amplatzer Cardiac Plug and the Amulet. Catheter Cardiovasc Interv,2017,90(5):E111-E121.
• [3] Dukkipati SR, Kar S, Holmes DR, et al. Device-related thrombus after left atrial appendage closure:incidence, Predictors,and outcomes. Circulation, 2018,138(9):874-885.
• [4] Bai Y, Xue X, Duenninger E, et al. Real-world survival data of device-related thrombus following left atrial appendage closure:4-year experience from a single center. Heart Vessels, 2019,34(8):1360-1369.
• [5]姚青，宋治远，郭燕丽，等.经皮左心耳封堵术在非瓣膜性心房颤动患者中的应用——单中心经验.中国介入心脏病学杂志，2018,26(10):553-558.
• [6] Xue X, Jiang L, Duenninger E, et al. Impact of chronic kidney disease on Watchman implantation:experience with 300 consecutive left atrial appendage closures at a single center. Heart Vessels, 2018,33(9):1068-1075.
• [7] Wiebe J, Franke J, Lehn K, et al. Percutaneous left atrial appendage closure with the watchman device:long-term results up to 5 Years. JACC Cardiovasc Interv, 2015,8(15):1915-1921.
• [8] Matsuo Y, Sandri M, Mangner N, et al. Interventional closure of the left atrial appendage for stroke prevention-experience of a highvolume center. Circ J, 2014,78(3):619-624.
• [9] Huang WP, Zhang YH, He L, et al. Efficacy and Safety of the WATCHMAN left atrial appendage system for stroke prevention in chinese patients with nonvalvular atrialfibrillation:a single-center,prospective, observational study. Chin Med J(Engl), 2017,130(4):434-438.
• [10] Fauchier L, Cinaud A, Brigadeau F, et al. Device-related thrombosis after percutaneous left atrial appendage occlusion for atrialfibrillation. JACC, 2018,71(14):1528-1536.
• [11] Enomoto Y, Gadiyaram VK, Gianni C, et al. Use of non-warfarin oral anticoagulants instead of warfarin during left atrial appendage closure with the Watchman device. Heart Rhythm, 2017,14(1):19-24.
• [12] Saw J, Fahmy P, Azzalini L, et al. Early canadian multicenter experience with WATCHMAN for percutaneous left atrial appendage closure. J Cardiovasc Electrophysiol, 2017,28(4):396-401.
• [13] Boersma LV, Ince H, Kische S, et al. Efficacy and safety of left atrial appendage closure with WATCHMAN in patients with or without contraindication to oral anticoagulation:1-Year follow-up outcome data of the EWOLUTION trial. Heart Rhythm, 2017,14(9):1302-1308.
• [14] Reddy VY, M?bius-Winkler S, Miller MA, et al. Left atrial appendage closure with the Watchman device in patients with a contraindication for oral anticoagulation:the ASAP study(ASA Plavix Feasibility Study With Watchman Left Atrial Appendage Closure Technology). J Am Coll Cardiol, 2013,61(25):2551-2556.