The value of cardiac computed tomography in assessing device endothelialization after left atrial appendage closure

doi:10.3877/cma.j.issn.2095-6568.2022.01.005

Abstract

Abstract:

Objective

This study aimed to evaluate endothelialization of left atrial appendage closure(LAAC) device (Watchman, Boston Scientific Corporation, USA)by cardiac computed tomography(CCT).

Methods

This was a single center retrospective study. Patients with non-valvular atrial fibrillation who underwent Watchman left atrial appendage closure were consecutively enrolled. Cardiac CT was used to evaluate the endothelialization degree of Watchman device at 6-month follow-up post procedure.

Results

A total of 64 patients were included. The age was (74.8±8.4) years old, and 22(34.4%, 22/64) of them were female. Watchman device was successfully implanted in each patient. At 6-month follow-up, complete endothelialization were detected in 40 patients (62.5%, 40/64), while incomplete endothelialization were detected in 24 patients (37.5%, 24/64). The levels of cholesterol [(3.91±1.00) mmol/L vs. (3.40±0.73) mmol/L,P=0.036], triglyceride [(1.44±0.74) mmol/L vs. (1.02±0.45) mmol/L,P=0.009] and low density lipoprotein [(2.19±0.86) mmol/L vs. (1.68±0.51) mmol/L,P=0.005] was higher in complete endothelialized group, than that of in incomplete endothelialized groups.

Conclusion

It is feasible to evaluate the degree of endothelialization of Watchman device post LAAC by CCT.

Key words: Atrial fibrillation, Left atrial appendage closure, Endothelialization, Cardiac computed tomography

Mingzhe Zhao, Binfeng Mo, Jian Sun, Pengpai Zhang, Wei Li, Rui Zhang, Mu Chen, Runmin Chi, Qunshan Wang, Yigang Li. The value of cardiac computed tomography in assessing device endothelialization after left atrial appendage closure[J]. Chinese Journal of Heart and Heart Rhythm(Electronic Edition), 2022, 10(01): 18-22.

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URL: https://zhxzyxldzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-6568.2022.01.005

https://zhxzyxldzzz.cma-cmc.com.cn/EN/Y2022/V10/I01/18

Figures/Tables 1

项目	总体	完全内皮化+残余分流组	不完全内皮化组	P值
人数（例）	64	40	24
年龄（岁， $x ¯ ± s$ ）	74.8±8.4	75.0±9.1	74.4±7.4	0.778
女［例（%）］	22（34.4）	14（35.0）	8（33.3）	0.892
合并症［例（%）］
高血压	43（67.2）	30（75.0）	13（54.2）	0.143
糖尿病	11（17.2）	10（25.0）	1（4.2）	0.079
丙氨酸氨基转移酶（U/L， $x ¯ ± s$ ）	25.4±24.9	26.9±30.2	22.8±13.5	0.542
血肌酐（μmol/L， $x ¯ ± s$ ）	80.6±24.2	79.4±21.3	82.6±29.3	0.619
NT-proBNP（pg/ml， $x ¯ ± s$ ）	1 407.1±1377.1	1 456.6±1666.0	1 323.3±734.1	0.718
总胆固醇（mmol/L， $x ¯ ± s$ ）	3.71±0.93	3.91±1.00	3.40±0.73	0.036^*
甘油三酯（mmol/L， $x ¯ ± s$ ）	1.27±0.66	1.44±0.74	1.02±0.45	0.009^*
低密度脂蛋白（mmol/L， $x ¯ ± s$ ）	1.99±0.77	2.19±0.86	1.68±0.51	0.005^*
左心耳开口最大直径（mm， $x ¯ ± s$ ）	24.4±4.2	24.1±4.4	25.1±4.0	0.369
左心耳封堵装置直径（mm， $x ¯ ± s$ ）	29.3±3.7	29.0±3.9	29.9±3.4	0.376

项目	总体	完全内皮化+残余分流组	不完全内皮化组	P值
人数（例）	64	40	24
年龄（岁， $x ¯ ± s$ ）	74.8±8.4	75.0±9.1	74.4±7.4	0.778
女［例（%）］	22（34.4）	14（35.0）	8（33.3）	0.892
合并症［例（%）］
高血压	43（67.2）	30（75.0）	13（54.2）	0.143
糖尿病	11（17.2）	10（25.0）	1（4.2）	0.079
丙氨酸氨基转移酶（U/L， $x ¯ ± s$ ）	25.4±24.9	26.9±30.2	22.8±13.5	0.542
血肌酐（μmol/L， $x ¯ ± s$ ）	80.6±24.2	79.4±21.3	82.6±29.3	0.619
NT-proBNP（pg/ml， $x ¯ ± s$ ）	1 407.1±1377.1	1 456.6±1666.0	1 323.3±734.1	0.718
总胆固醇（mmol/L， $x ¯ ± s$ ）	3.71±0.93	3.91±1.00	3.40±0.73	0.036^*
甘油三酯（mmol/L， $x ¯ ± s$ ）	1.27±0.66	1.44±0.74	1.02±0.45	0.009^*
低密度脂蛋白（mmol/L， $x ¯ ± s$ ）	1.99±0.77	2.19±0.86	1.68±0.51	0.005^*
左心耳开口最大直径（mm， $x ¯ ± s$ ）	24.4±4.2	24.1±4.4	25.1±4.0	0.369
左心耳封堵装置直径（mm， $x ¯ ± s$ ）	29.3±3.7	29.0±3.9	29.9±3.4	0.376

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