Predicting Peri-Device Leakage of Left Atrial Appendage Device Closure Using Novel Three-Dimensional Geometric CT Analysis
Journal of Cardiovascular Ultrasound
;
: 211-218, 2015.
Artículo
en Inglés
| WPRIM
| ID: wpr-38859
ABSTRACT
BACKGROUND:
After left atrial appendage (LAA) device closure, peri-device leakage into the LAA persists due to incomplete occlusion. We hypothesized that pre-procedural three-dimensional (3D) geometric analysis of the interatrial septum (IAS) and LAA orifice can predict this leakage. We investigated the predictive parameters of LAA device closure obtained from baseline cardiac computerized tomography (CT) using a novel 3D analysis system.METHODS:
We conducted a retrospective study of 22 patients who underwent LAA device closure. We defined peri-device leakage as the presence of a Doppler signal inside the LAA after device deployment (group 2, n = 5) compared with patients without peri-device leakage (group 1, n = 17). Conventional parameters were measured by cardiac CT. Angles theta and phi were defined between the IAS plane and the line, linking the LAA orifice center and foramen ovale.RESULTS:
Group 2 exhibited significantly better left atrial (LA) function than group 1 (p = 0.031). Pre-procedural theta was also larger in this group (41.9degrees vs. 52.3degrees, p = 0.019). The LAA cauliflower-type morphology was more common in group 2. Overall, the patients' LA reserve significantly decreased after the procedure (21.7 mm3 vs. 17.8 mm3, p = 0.035). However, we observed no significant interval changes in pre- and post-procedural values of theta and phi in either group (all p > 0.05).CONCLUSION:
Angles between the IAS and LAA orifice might be a novel anatomical parameter for predicting peri-device leakage after LAA device closure. In addition, 3D CT analysis of the LA and LAA orifice could be used to identify clinically favorable candidates for LAA device closure.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Estudios Retrospectivos
/
Apéndice Atrial
/
Foramen Oval
Tipo de estudio:
Estudio observacional
/
Estudio pronóstico
Límite:
Humanos
Idioma:
Inglés
Revista:
Journal of Cardiovascular Ultrasound
Año:
2015
Tipo del documento:
Artículo
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