循環器ジャーナル72巻3号

2024年07月発行

特集 心房細動—予防・早期発見・治療の進化 Ⅴ.抗凝固療法

カテーテルを用いた左心耳閉鎖術の現在・未来は？

著者： 龍崎智子¹ 近藤祐介²

所属機関： ¹千葉大学大学院医学研究院不整脈先進医工学 ²千葉大学大学院医学研究院循環器内科学

ページ範囲：P.451 - P.458

POINT
●経皮的左心耳閉鎖はデバイスの進歩とともに外科手技から血管内治療へ変遷し，心房細動に伴う血栓塞栓症の予防治療として確実に効果が期待できる．
●欧米ではWATCHMAN^TMデバイスだけでも40万件の実施例が報告されており，本邦での導入が大いに期待されたが，保険償還ののちに左心耳閉鎖が爆発的に普及することはなかった．予想外の普及の遅れの原因はいったい何なのか，歴史からひもといて検討したい．
●施術後の抗血栓療法は多数報告があるが，日本人に最適な抗血栓療法のレジュメは議論の余地のあるところである．

参考文献

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