Zhengzhou Seventh People's Hospital official headline number
At 12:00 on June 24, 2022, the medical team led by Zhao Yujie, deputy director and director of the cardiology department of Zhengzhou Seventh People's Hospital, treated a patient with two cerebral embolism , A middle-aged patient with atrial fibrillation , patent foramen ovale was successfully treated with atrial fibrillation catheter radiofrequency ablation + left atrial appendage sealing device (WATCHMAN FLX) implantation + patent foramen ovale closure surgery. The left atrial appendage occlusion device (WATCHMAN FLX), as one of the first new technologies to enter clinical use in China, will bring more diversified treatment options for the prevention of stroke for patients with atrial fibrillation in the Central Plains area.
According to Zhao Yujie, the patient, Mr. Sun, was 49 years old and had suffered from intermittent heart palpitations for more than 22 years. Until half a month ago, he suddenly suffered from hemiplegia of the right limb and aphasia. He went to the local hospital and was diagnosed with "acute cerebral infarction" and was given thrombolytic treatment. Later, the symptoms of hemiplegia and aphasia of the right limb were relieved. Further comprehensive examination found no cerebrovascular abnormality, but the electrocardiogram showed "arrhythmia and atrial fibrillation", so he was treated with oral anticoagulants and other treatments. However, misfortunes never come singly. One week ago, Mr. Sun developed left limb weakness again and was transferred to our hospital for urgent brain MRI. It showed: multiple lacunar lesions in bilateral insula, frontal, parietal lobe, right temporal lobe and right lateral ventricle. cerebral infarction. Further examination showed that in addition to atrial fibrillation, Mr. Sun also had a patent foramen ovale (right heart contrast echocardiography and foaming test showed the strongest grade) combined with atrial septal bulge tumor . The young Mr. Sun and his severe "senile diseases" forced Zhao Yujie's team to seriously explore the further treatment of Mr. Sun's atrial fibrillation and patent foramen ovale. After drug treatment, Mr. Sun's limb muscle strength returned to normal, and his general condition improved significantly. The preoperative CTA of the left atrium and pulmonary veins did not reach thrombus . After consultation with the neurology department, and based on the wishes of Mr. Sun and his family, Zhao Yujie's team decided to target Mr. Sun's intracardiac infarction. Ultrasound (ICE) guided one-stop treatment of minimally invasive left atrial appendage occlusion device + atrial fibrillation catheter radiofrequency ablation + patent foramen ovale closure.
Mr. Sun's situation was special. Zhao Yujie's team monitored closely during the operation. Zhao Yujie performed the surgery himself and placed the first domestic new generation left atrial appendage occluder in a shorter time. Later, he performed catheter ablation to reverse atrial fibrillation and return it to normal. sinus rhythm , finally Mr. Sun, who had atrial septal bulge and patent foramen ovale, underwent patent foramen ovale closure.
Transcatheter radiofrequency ablation is a minimally invasive catheter technology that has been developed around the world for more than 20 years and is a very mature and safe technology. Left atrial appendage occlusion is a minimally invasive treatment. It is currently the leading international solution for preventing cerebral infarction in patients with non-valvular atrial fibrillation. It can solve the risk of stroke in patients with atrial fibrillation from the source and has been used globally. Has been widely used.
Mr. Sun restored sinus rhythm during catheter ablation of atrial fibrillation
It is understood that in China, at least 1 out of every 5 deaths occurs from stroke. The risk of stroke in patients with atrial fibrillation is five times that of the general population, as high as 20-30%. Compared with strokes caused by other causes, strokes caused by atrial fibrillation have the characteristics of "high disability rate, high mortality rate, and high recurrence rate", which brings great suffering to patients and families. In non-valvular atrial fibrillation, more than 90% of thrombus formation is related to left atrial appendage .
In view of the problem that patients with atrial fibrillation are prone to thrombus in the left atrial appendage of the heart and cause stroke, by blocking the left atrial appendage, it can help patients with non-valvular atrial fibrillation effectively prevent the occurrence of stroke and help patients get rid of oral antibiotics. Lifelong dependence on coagulant drugs. As an innovative "sharp tool" for the prevention of atrial fibrillation and stroke, since it was first used in humans in 2002, more than 200,000 surgeries have been completed around the world, and nearly 30,000 surgeries have been completed in China.
Mr. Sun’s left atrial appendage occlusion device (WATCHMAN FLX) was inserted
“In 2008, he started atrial fibrillation catheter radiofrequency ablation surgery. There are about 1,600 cases of arrhythmia catheter ablation every year, and more than 600 cases of atrial fibrillation catheter ablation every year.With the improvement of screening methods, such as wristbands, watches, long-term ECG monitoring, and increased attention, the number of atrial fibrillation surgeries is increasing year by year. "Zhao Yujie said. "Compared with the first generation left atrial appendage occlusion device, the left atrial appendage occlusion device (WATCHMAN FLX) has obvious advantages. The operation is safer and less likely to cause atrial appendage perforation, pericardial tamponade ; the sealing after closure is better, the operation is simpler, and the operation is easy to master; the closure is more stable and difficult to fall off; it can also be performed on complex atrial appendages. Blocking; can reduce the incidence of device-related thrombus; simplify the operation process and effectively shorten the operation time.
Mr. Sun’s left atrial appendage sealing device (WATCHMAN FLX) + patent foramen ovale sealing umbrella after placement
How to prevent atrial fibrillation patients? Zhao Yujie recommends that you must reduce some stimulating foods, tea, wine, etc.; patients with relatively high levels of blood lipids and , heavy taste in food, obesity, and prone to snoring may consider losing weight to improve sleep apnea and lower blood lipids. , which is an upstream treatment to prevent atrial fibrillation.
It is understood that Mr. Sun returned to the general ward after the operation and is currently recovering smoothly.
