张晓春

• 1:中国医师协会心血管内科医师分会结构性心脏病学组
• 2:苏州工业园区东方华夏心血管健康研究院
• 3:复旦大学附属中山医院

摘要(Abstract)：

本共识聚焦经导管左心耳封堵术（LAAC），鉴于心房颤动（房颤）患者增多及LAAC技术进展与临床需求变化，中国医师协会心血管内科医师分会结构性心脏病学组对此进行了更新。房颤发病率随人口老龄化而攀升，房颤引发的脑卒中风险高，而LAAC则是有效预防途径。共识详细阐述LAAC的发展脉络，包括在房颤综合管理中的关键意义、我国的里程碑事件及丰富的循证依据。在团队构建上，明确了涵盖多科室专业人员的配置及精细分工。明确适应证为高脑卒中风险且特定评分达标的非瓣膜性房颤患者，同时列出禁忌证。全面解析方法学，从影像评估[如（经胸超声心动图（TTE）、经食管超声心动图（TEE）、心脏CT血管造影（CTA）作用及要点]、不同封堵器操作（塞式或盘式封堵器的选择、置入、评估及调整流程）到围术期管理各环节均有涉及。梳理围术期并发症，涵盖心包积液、脑卒中、封堵器脱落等，分析成因并给出处理策略。术后抗栓治疗依阶段（强化、巩固及特殊患者情形）制订策略，同时详述随访计划（节点、方式、内容及结果判定）。术式选择介绍“一站式”与简化式特点及适用场景，展望未来聚焦适用人群拓展、技术完善、器械创新、联合治疗深化及用药策略优化，为LAAC临床实践与发展提供全方位、精准且具前瞻性的指引，有力推动其规范化、精准化及持续创新。

关键词(KeyWords)： 心房颤动;左心耳;封堵术;临床路径;专家共识

Abstract:

Keywords:

基金项目(Foundation): 上海市创新医疗器械应用示范项目（2 3 S H S 0 0 7 0 0）;; 上海市科技创新行动计划项目（24SF1906600）;; 上海市临床医学研究中心项目（19MC1910300）;; 国家自然科学基金项目（82470377、82200457）

作者(Author): 张晓春

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