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Assessment of peri-device leaks after interventional left atrial appendage closure using standardized imaging by cardiac computed tomography angiography

Cardiac computed tomography angiography (cCTA) has recently been proposed for evaluation of successful interventional left atrial appendage closure (LAA/LAAC). This prospective longitudinal observational study aims to assess this proposal by applying a standardized imaging protocol to detect and qua...

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Main Authors: Lindner, Simon (Author) , Behnes, Michael (Author) , Wenke, Annika (Author) , Sartorius, Benjamin (Author) , Ansari, Uzair (Author) , Akın, Muharrem (Author) , Mashayekhi, Kambis (Author) , Vogler, Nils (Author) , Haubenreisser, Holger (Author) , Schönberg, Stefan (Author) , Borggrefe, Martin (Author) , Akın, Ibrahim (Author)
Format: Article (Journal)
Language:English
Published: 2019
In: The international journal of cardiovascular imaging
Year: 2019, Volume: 35, Issue: 4, Pages: 725-731
ISSN:1875-8312
DOI:10.1007/s10554-018-1493-z
Online Access:Verlag, Volltext: https://doi.org/10.1007/s10554-018-1493-z
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Author Notes:Simon Lindner, Michael Behnes, Annika Wenke, Benjamin Sartorius, Uzair Ansari, Muharrem Akin, Kambis Mashayekhi, Nils Vogler, Holger Haubenreisser, Stefan O. Schoenberg, Martin Borggrefe, Ibrahim Akin
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Summary:Cardiac computed tomography angiography (cCTA) has recently been proposed for evaluation of successful interventional left atrial appendage closure (LAA/LAAC). This prospective longitudinal observational study aims to assess this proposal by applying a standardized imaging protocol to detect and quantify peri-device leaks (PDL) after LAAC. cCTA datasets of consecutive patients 6 months after successful LAAC were acquired on a third generation dual-source computed tomography system and reconstructed with a slice thickness of 0.5 mm. The standardized multi-planar reconstruction LAA occluder view for post-implantation evaluation (LOVE) algorithm was used to assess PDL in relation to LAA morphology and implanted LAAC devices. A total of 49 patients (median age 80 years, 24% female) were included consecutively. Overall PDL rate was 31%. Leak rates among different left atrial appendage morphologies varied largely. Windsock type had the highest incidence of PDL (47%). AMPLATZER™ AMULET™ device type revealed slightly higher PDL rates than WATCHMAN™ type and showed larger leaks. However, no statistical differences were found. PDL can be sized best in LOVE sagittal views, whereas a synopsis of LOVE sagittal, axial and coronal views allows further examination and detection of small leaks. PDL are common after successful interventional LAAC, which can be accurately detected and sized by standardized cCTA imaging protocols.
Item Description:First online: 12 November 2018
Gesehen am 31.01.2020
Physical Description:Online Resource
ISSN:1875-8312
DOI:10.1007/s10554-018-1493-z

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