Left Atrial Appendage Occlusion/Exclusion: Procedural Image Guidance with Transesophageal Echocardiography

Vainrib, Alan F.; Harb, Serge C.; Jaber, Wael A.; Benenstein, Ricardo; Aizer, Anthony; Chinitz, Larry A.

doi:10.1016/j.echo.2017.09.014

Cited by 55 publications

(53 citation statements)

References 35 publications

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“…However, full assessment of the morphology and size of the LAA before surgery can improve the success rate and effectiveness of such occlusion. [12][13][14] In this study, transesophageal echocardiography (TEE), LAA angiography, cardiac computed tomography angiography (CTA), and threedimensional (3D) reconstruction model of the heart based on CTA were used to fully evaluate the morphology and structure of the LAA to improve the success rate and effect of LAA occlusion.…”

Section: Introductionmentioning

confidence: 99%

Application of transesophageal echocardiography, left atrial appendage angiography, cardiac computed tomography angiography, and three-dimensional reconstruction model in left atrial appendage occlusion

Huang

Kang

Yuan

et al. 2020

International Journal of Distributed Sensor Networks

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Objective: The objective was to evaluate the application of transesophageal echocardiography, left atrial appendage angiography, cardiac computed tomography angiography, and three-dimensional reconstruction model in the left atrial appendage occlusion. Methods: A total of 53 patients with persistent atrial fibrillation hospitalized from January 2015 to February 2019 were selected. Transesophageal echocardiography and cardiac computed tomography angiography were performed simultaneously before operation, and three-dimensional reconstruction of the left atrial appendage model was performed based on the cardiac computed tomography angiography findings. The morphology and size of the left atrial appendage were displayed by the left atrial appendage angiography during the operation. Results: Cardiac computed tomography angiography revealed filling defects in the left atrial appendage in four patients, whereas transesophageal echocardiography revealed thrombosis in two patients of the four patients. According to the cardiac computed tomography angiography results, the morphology of the left atrial appendage was classified into chicken wing–like, cauliflower-like, wind vane–like, and cactus-like. The diameters and depths of the left atrial appendage measured by cardiac computed tomography angiography and three-dimensional reconstruction model were found to be the greatest, and the orifice sizes and depths of the left atrial appendage measured by the left atrial appendage angiography were the smallest. Conclusion: Transesophageal echocardiography, left atrial appendage angiography, cardiac computed tomography angiography, and three-dimensional reconstruction model can evaluate the morphology and size of the left atrial appendage. The cardiac computed tomography angiography and three-dimensional reconstruction model could demonstrate the internal structure of the left atrial appendage more clearly.

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Section: Introductionmentioning

confidence: 99%

Application of transesophageal echocardiography, left atrial appendage angiography, cardiac computed tomography angiography, and three-dimensional reconstruction model in left atrial appendage occlusion

Huang

Kang

Yuan

et al. 2020

International Journal of Distributed Sensor Networks

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“…Precise delineation of the LAA anatomy is essential for appropriate patient selection and intraprocedural guidance. In this setting, two‐dimensional (2D) and three‐dimensional (3D) transesophageal echocardiography (TEE) has been the primary imaging modality in addition to computed tomography …”

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confidence: 99%

“…In this setting, two-dimensional (2D) and three-dimensional (3D) transesophageal echocardiography (TEE) has been the primary imaging modality in addition to computed tomography. [1][2][3] Recent improvements in 3D TEE postprocessing rendering techniques referred to as TrueVue (Philips Medical Systems). It allows for novel photorealistic imaging of cardiac structures including left atrial appendage (LAA) and its closure devices.…”

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confidence: 99%

Photorealistic imaging of left atrial appendage occlusion/exclusion

et al. 2019

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Recent improvements in 3D TEE post processing rendering techniques referred to as TrueVue (Philips Medical Systems, Andover, MA, USA). It allows for novel photorealistic imaging of cardiac structures including left atrial appendage (LAA) and its closure devices. Here we present TrueVue images of the LAA prior to and after LAA exclusion/occlusion using various percutaneous and surgical techniques. TrueVue may improve delineation of LAA anatomy prior to occlusion as well as visualization of occluder device position within the LAA.

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“…Other LAA occlusion devices are currently in clinical trials in the US, such as the Amulet device (St. Jude Medical, Minneapolis, MN). 1,3 The Lariat device (Sentre-HEART, Palo Alto, CA) is also currently being used in clinical practice, but differs from the occlusion devices in that it is an exclusion device which is used to ligate the LAA. 3 The purpose of all these devices is to close off the LAA so that a LAA thrombus cannot embolize, thus saving the patient from a detrimental outcome, such as a stroke.…”

mentioning

confidence: 99%

“…It is always important to make sure a pericardial effusion is not developing during the procedure, as this would suggest a perforation. 3 After device implantation, the patients will receive additional TEEs to confirm the device is still in good position and stable, without a significant residual leak, and without any thrombus formation on the device. 3 Ideally, AFib patients with LAA occlusion can eventually discontinue anticoagulant use, dramatically reducing their morbidity and mortality and improving quality of life.…”

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confidence: 99%

Structural Heart Imaging: Focus on Left Atrial Appendage Occlusion

Billick¹

2019

Journal of the American Society of Echocardiography

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Most sonographers see atrial fibrillation (AFib) patients on a daily basis. This is not surprising, as AFib is the most common arrhythmia and will be seen more frequently as people are living longer. 1-3 In fact, it is estimated that AFib prevalence will increase from the current >3 million people to 7.56 million people by 2050. 1-3 The potential for stroke in AFib patients is high, as thrombus can form within the LAA. 4 Seventy five percent of cardioembolic events are thought to arise from the LAA and are assumed to be a result of AFib. 4 Up until recently, AFib patients were either anticoagulated or, in some cases, surgical exclusion of the LAA was done. However, this is typically in conjunction with other cardiac procedures. 3 Anticoagulants subject patients to a considerable risk of bleeding and, in some patients, may be contraindicated. 3

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Left Atrial Appendage Occlusion/Exclusion: Procedural Image Guidance with Transesophageal Echocardiography

Cited by 55 publications

References 35 publications

Application of transesophageal echocardiography, left atrial appendage angiography, cardiac computed tomography angiography, and three-dimensional reconstruction model in left atrial appendage occlusion

Application of transesophageal echocardiography, left atrial appendage angiography, cardiac computed tomography angiography, and three-dimensional reconstruction model in left atrial appendage occlusion

Photorealistic imaging of left atrial appendage occlusion/exclusion

Structural Heart Imaging: Focus on Left Atrial Appendage Occlusion

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