Geometry of left atrial appendage assessed with multidetector-row computed tomography: implications for transcatheter closure devices.

Abstract

AIMS:

To assess the left atrial appendage (LAA) geometry with multidetector-row computed tomography (MDCT) and its implications for selection of closure devices.

METHODS AND RESULTS:

One hundred and ninety-seven patients who underwent MDCT prior to catheter ablation for atrial fibrillation were evaluated. Feasibility for Watchman and Amplatzer Cardiac Plug (ACP) devices was assessed based on the maximal cross-sectional diameter and perimeter of the ostium and at 10 mm depth and on the LAA diameter on the MDCT plane resembling the transoesophageal echocardiography (TEE) view. Mean maximal diameters of the ostium and at 10 mm depth were 28.7±4.4 mm and 24.6±4.5 mm, respectively, resulting in feasibilities of 80.7%, 84.8% and 91.4% for the Watchman, the ACP and for either one of the two devices, respectively. Mean perimeters of the ostium and at 10 mm depth were 79.1±12.2 mm and 69.8±11.6 mm, resulting in feasibilities of 87.8%, 92.9% and 96.4% for the Watchman, the ACP and for either one of the two devices, respectively. Mean TEE-like MDCT LAA diameter was 22.0±3.3 mm, resulting in feasibilities of 93.9%, 97% and 99.0% for the Watchman, the ACP and for either one of the two devices, respectively.

CONCLUSIONS:

The feasibility of current devices is high, based on MDCT measurements of the LAA, with no difference for either one of the devices.

• Authors: Philippe J van Rosendael, Spyridon Katsanos, Olivier W V van den Brink, Arthur J H A Scholte, Serge A Trines, Jeroen J Bax, Martin J Schalij, Nina Ajmone Marsan, Victoria Delgado
• Journal: EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology (EuroIntervention) Vol. 10 Issue 3 Pg. 364-71 (Jul 2014) ISSN: 1969-6213 [Electronic] France
• PMID: 24273250 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Aged
• Atrial Appendage (diagnostic imaging)
• Atrial Fibrillation (diagnostic imaging, therapy)
• Cardiac Catheterization (instrumentation)
• Catheter Ablation
• Equipment Design
• Feasibility Studies
• Female
• Humans
• Male
• Middle Aged
• Multidetector Computed Tomography
• Patient Selection
• Predictive Value of Tests
• Radiographic Image Interpretation, Computer-Assisted
• Retrospective Studies