心房細動に対する左心耳閉鎖クリップを用いた左心耳閉鎖術の早期～遠隔期成績

Early to Long-term Results of Left Atrial Appendage Closure Using Clip Device in Patients with Atrial Fibrillation

心房細動患者に対する脳梗塞予防の標準的アプローチは，経口抗凝固薬の内服とされている．しかし，抗凝固薬内服療法は出血性合併症はもちろんのこと，適切な薬物療法施行下でも脳梗塞発症のリスクがある．また近年では左心耳をターゲットとした外科治療も発達してきており，左心耳閉鎖術（LAAO），左心耳切除術（LAAR）があげられる．

Oral anticoagulants for atrial fibrillation are the standard approach to prevent stroke in patients with atrial fibrillation. However, oral anticoagulant therapy carries the risk of cerebral infarction recurrence, not to mention hemorrhagic complications, even under appropriate drug therapy. Surgical treatments targeting the left atrial appendage include left atrial appendage closure （LAAO） and left atrial appendage resection （LAAR）. Our hospital uses AtriClip （approved and available in Japan since 2018） as a device for LAAO, and we investigated the early and long-term results of LAAO using AtriClip in our hospital. As a result, stable early to long-term results were expected for left atrial appendage closure using AtriClip device, suggesting that it may be an option that can be considered as a method for preventing stroke in patients with atrial fibrillation. But further investigation is required in the future.