scholarly journals 1094 Contrast microbubbles for assessment of left atrial appendage morphology and function during pre-cardioversion transesophageal echocardiography: useful or not?

2006 ◽  
Vol 7 ◽  
pp. S189-S189 ◽  
Author(s):  
S ABDELMONEIM ◽  
S MOIR ◽  
N AMMASH ◽  
K CHANDRASEKARAN ◽  
P SPITTELL ◽  
...  
2012 ◽  
pp. 36-42
Author(s):  
Thuc Quang Bui ◽  
Dien Bien Vu ◽  
Nguyen Son Pham

Objectives: To evaluate size and function of left atrium and left atrial appendage (LAA) by using transthoracic and transesophageal echocardiography in nonvalvular atrial fibrillation (NVAF) patients. Method: 127 NVAF patients (mean age 65,8 ± 10,0 years) were assessed by using CHADS2 and CHADS2-VAS score, transthoracic and transesophageal echocardiographic parameters. Results: CHADS2 ≥3, CHADS2-VAS ≥ 4 and LAVI ≥ 38ml/m2, diagnosis of LAA thrombus has been expected in turn with Se=67% and Sp=70%, Se=67% and Sp=71% and Se=80% and Sp=60%; With LEVF/LAVI ≤1,5, risk of LAA thrombus was OR=13,3; 95% CI (1,8 – 98,5) with p=0,001. Conclusion: CHADS2, CHADS2-VAS, LAVI and ratio LVEF/LAVI are predictors of LAA thrombus in NVAF patients. Key words: CHADS 2, CHADS 2 -VAS, left atrial appendage thrombus, thromboembolism, nonvalvular atrial fibrillation


1998 ◽  
Vol 15 (3) ◽  
pp. 243-256 ◽  
Author(s):  
SIU-SUN YAO ◽  
JAY S. MEISNER ◽  
STEPHEN M. FACTOR ◽  
CHARLES W. FRANK ◽  
JOEL A. STROM ◽  
...  

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Afonso B. Freitas-Ferraz ◽  
Mathieu Bernier ◽  
Kim O’Connor ◽  
Jonathan Beaudoin ◽  
Jean Champagne ◽  
...  

Abstract Background In patients undergoing left atrial appendage (LAA) closure, an accurate sizing of the LAA is key to optimize device sizing, procedural success and reduce complications. Previous studies have shown that intraprocedural volume loading increases LAA dimensions and improves device sizing. However, the safety and effects on LAA and device sizing of administering a fluid bolus during pre-procedural transesophageal echocardiography (TEE) are unknown. The aim of this study was to determine the safety and impact on LAA dimensions and device sizing of an intravenous (IV) fluid bolus administered during TEE in the setting of the pre-procedural work-up for LAA closure. Methods The study included a total of 72 patients who underwent TEE to assess suitability for LAAC and received a 500 ml IV bolus of normal saline. The LAA landing zone (LZ) and depth were measured by TEE before and after volume loading, and these measurements were used to predict the device size implanted during a subsequent percutaneous LAAC procedure. Results There were no complications associated with volume loading. The baseline mean LZ was 19.6 ± 3.6 mm at 90o, and 20.2 ± 4.1 mm at 135o. Following fluid bolus, the maximum diameter increased 1.5 ± 1.0 mm at 90o (p<0.001), and 1.3 ± 1.0 mm at 135o (p<0.001). The baseline mean depth of the LAA was 26.5 ± 5.5 mm at 90o, and 23.9 ± 5.8 mm at 135o. After fluid bolus, the mean depth increased by 1.5 ± 1.8 mm (p<0.001) and 1.6 ± 2.0 (p<0.001), at 90o and 135o, respectively. Sizing based on post-bolus measurements of the LZ significantly improved the agreement with the final device size selection during the procedure in 71.0% of cases (vs. 42.0% with pre-bolus measurements). Conclusions Volume loading during ambulatory TEE as part of the pre-procedural work-up of LAAC is safe and significantly increases LAA dimensions. This strategy may become the new standard, particularly in centers performing LAAC with no TEE guidance, as it improves LAA sizing and more accurately predicts the final device size.


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