首页|基于CCTA研究房颤患者行胸腔镜下LAAL术后左心耳形态与残余分流的相关性

基于CCTA研究房颤患者行胸腔镜下LAAL术后左心耳形态与残余分流的相关性

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目的:基于术后心脏 CT 血管成像(CCTA)技术,分析房颤(AF)患者行胸腔镜下左心耳缝扎术(LAAL)后残余分流(PDL)与左心耳(LAA)形态的关系.方法:选择暨南大学附属第一医院2017 年11 月至2023年4 月间成功实施LAAL的AF患者62 例,收集其临床资料,评估其术后CCTA图像并分析LAA形态学指标.根据LAAL术后复查结果将患者分为有PDL组(n=34)及无PDL组(n=28).对两组患者之间具有统计学差异的各项指标进行Logistic回归分析,寻找危险因素.结果:将LAA各项参数指标纳入单因素Logistic回归进行分析,结果显示LAA短径(OR=0.393,95%CI:0.167~0.926,P=0.033)、LAA 口长径(OR=0.330,95%CI:0.138~0.785,P=0.012)、LAA口短径(OR=0.083,95%CI:0.019~0.367,P=0.001)、LAA口周长(OR=0.078,95%CI:0.510~0.983,P=0.039)、LAA口面积(OR=0.499,95%CI:0.319~0.783,P=0.002)及LAA体积(OR=0.855,95%CI:0.768~0.953,P=0.005)均与术后PDL的发生相关.经多因素Logistic回归校正后,LAA口短径更长为PDL发生的独立危险因素.结论:经CCTA行LAA形态学评估对AF患者LAAL术后PDL的发生具有一定的预测价值,当LAA口短径较长时,需警惕PDL的发生.
The correlation between left atrial appendage morphology and peri-device leak after thoracoscopic LAAL in patients with atrial fibrillation based on CCTA
Objective:To analyze the correlation between peri-device leak(PDL)after thoracoscopic left atrial appendage ligation(LAAL)in patients with atrial fibrillation(AF)and left atrial appendage(LAA)morphology based on postoperative cardiac computed tomography angiography(CCTA).Methods:Sixty-two patients with AF who underwent successful LAAL at the First Affiliated Hospital of Jinan University from November 2017 to April 2023 were enrolled,as well as their clinical data.Their postoperative CCTA images were evaluated to assess LAA morphological parameter.Based on the follow-up results after LAAL,the patients were divided into two groups,the PDL group(n=34)and the non-PDL group(n=28).Logistic regression analysis was performed to identify significant risk factors among the variables with statistical differences between the two groups.Results:The parameters of the LAA between two groups were included in the single factor logistic regression analysis.The results showed that the short diameter of LAA(OR=0.393,95%CI:0.167~0.926,P=0.033),the long diameter of LAAO(OR=0.330,95%CI:0.138~0.785,P=0.012),the short diameter of LAAO(OR=0.083,95%CI:0.019~0.367,P=0.001),the perimeter of LAAO(OR=0.078,95%CI:0.510~0.983,P=0.039),the area of LAAO(OR=0.499,95%CI:0.319~0.783,P=0.002),and the volume of LAA(OR=0.855,95%CI:0.768~0.953,P=0.005)were associated with the occurrence of PDL.After multivariate logistic regression correction,that LAAO short diameter becomes longer was a risk factor for the occurrence of PDL.Conclusion:The assessment of LAA morphology through CCTA has a certain predictive value for the occurrence of postoperative PDL in AF patients.When the short diameter of LAAO becomes longer,we need to be alert to the occurrence of PDL.

cardiac computed tomography angiography(CCTA)thoracoscopicleft atrial appendage ligation(LAAL)peri-device leak(PDL)atrial fibrillation(AF)

程相宜、黄成锋、熊雨美、陆华、廖胜杰、张晓慎、王昊、沈思

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暨南大学 附属第一医院 医学影像科 心血管外科,广东 广州 510630

广州医科大学 附属妇女儿童医疗中心 急诊科,广东 广州 510180

心脏CT血管成像(CCTA) 胸腔镜 左心耳缝扎术(LAAL) 残余分流(PDL) 房颤(AF)

广州市科技计划广州市卫生健康委西医类一般引导项目

2023A03J104020211A010027

2024

暨南大学学报(自然科学与医学版)
暨南大学

暨南大学学报(自然科学与医学版)

CSTPCD北大核心
影响因子:0.996
ISSN:1000-9965
年,卷(期):2024.45(2)