Letter to the editor
Planning left atrial appendage occlusion using cardiac multidetector computed tomography

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Cited by (25)

  • Fusion Imaging for Procedural Guidance

    2018, Revista Espanola de Cardiologia
  • Computed tomography measurement of the left atrial appendage for optimal sizing of the Watchman device

    2018, Journal of Cardiovascular Computed Tomography
    Citation Excerpt :

    Deployment of an appropriately sized Watchman device is important, because device under-sizing may result in device embolization and peri-device leak, and device over-sizing can lead to perforation of the LAA and cardiac tamponade. Multi-detector cardiac computed tomography (MDCT) has been reported to be useful for the assessment of LAA morphology and anatomy.8,9 Limited data are available on the correlation of TEE and MDCT measurements of the LAA ostium for percutaneous LAA closure.

  • Morphologic Assessment of the Left Atrial Appendage in Patients with Atrial Fibrillation by Gray Values–Inverted Volume-Rendered Imaging of Three-Dimensional Transesophageal Echocardiography: A Comparative Study with Computed Tomography

    2016, Journal of the American Society of Echocardiography
    Citation Excerpt :

    TEE is used for screening suitable patients for occlusion procedures on the basis of the detection of thrombi and SEC in the LAA and on evaluations of the shape of the LAA, the size of the ostium, and the depth of the LAA.12,13 Cardiac computed tomography is the typical method used to image intraluminal contrast filling in the cardiac chamber and to reconstruct the full view of the LAA using CT-VR imaging.14 Some researchers suggest that computed tomography should be used for complementary anatomic assessments of the LAA beyond TEE-based assessments only in cases of LAAs with ostia >26 mm and with a complex anatomic structure.6

  • Left Atrial Appendage Exclusion for Atrial Fibrillation

    2016, Heart Failure Clinics
    Citation Excerpt :

    The velocity of the leak, the degree of residual exposed LAA anatomic complexity, and the ability of the leak to accommodate a thrombus may be different between patients with a surgical leak, epicardial ligation leak, and peridevice leak. In addition, an important unknown is how to determine when the appendage is adequately closed, and whether the definition should be anatomic, electrical, or functional7,10 and whether transesophageal or intracardiac echocardiography, CT, or MRI is the optimal imaging study.140,141,166,173–176 All closure devices and techniques leave a small beak, where tissues are approximated or adjacent to a device; whether these beaks affect stroke prevention is not known.

  • Left atrial appendage closure for stroke prevention emerging technologies

    2014, Cardiac Electrophysiology Clinics
    Citation Excerpt :

    Two registered studies will examine the effects of LAA occlusion using WATCHMAN on cardiac function including neurohormonal changes, the Effects of Left Atrial Appendage Occlusion study (NCT00510900) and the Atrial and Brain Natriuretic Peptide Secretion After Percutaneous Closure of the Left Atrial Appendage study (NCT01522911). Although ongoing studies are poised to answer several important questions related to LAA closure in reduction of stroke risk, several unknown factors remain, the first of which is determining when the appendage is adequately closed; whether the definition should be anatomic, electrical, or functional26,42; and whether transesophageal or intracardiac echocardiography, CT, or MRI is the optimal imaging study.102–108 All closure devices and techniques will leave a small “beak” where tissues are approximated or adjacent to a device; whether such a situation affects stroke prevention is not known.

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