Use of an echocardiographic contrast agent to establish safety of cardioversion in a patient with a ligated left atrial appendage

2003 ◽  
Vol 16 (12) ◽  
pp. 1316-1317 ◽  
Author(s):  
Michael W Farrar ◽  
Rhonda Taylor ◽  
Suzanne Gough
Keyword(s):  
Contrast Agent ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage

scholarly journals Impact of ultrasound contrast agent during transoesophageal echocardiography on the sizing of the left atrial appendage

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001403
Author(s):  
Henning Ebelt ◽  
Sarah Goetze ◽  
Anja Weida ◽  
Alexandra Offhaus
Keyword(s):  
Contrast Agent ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Ultrasound Contrast Agent ◽  
Transoesophageal Echocardiography ◽  
Atrial Appendage ◽  
Size Determination ◽  
Ultrasound Contrast ◽  
Increased Risk

IntroductionInterventional closure of the left atrial appendage closure (LAAC) has been established as an alternative treatment in patients with atrial fibrillation (AF) and an increased risk of stroke. So far it is unknown whether the use of ultrasound contrast agent (UCA) would influence the correct sizing of the LAA and thereby have an impact on device selection during interventional LAAC.MethodsBetween January 2017 and April 2018, 223 transoesophageal echocardiography (TOE) examinations were prospectively performed in adult patients with non-valvular AF (Impact of the use of ultrasound contrast agent on the detection of thrombi in the left atrial appendage during transesophageal echocardiography (CONDOR) study). LAA was examined both with and without the use of UCA. The following measurements were taken at 0o, 45o, 90o and 135o: diameter of LAA ostium, maximal depth of the LAA, maximal available depth of the LAA orthogonal to the ostial plane and area of the LAA.ResultsThe use of UCA had no relevant influence on the size determination of the LAA. Additionally, Bland-Altman blots demonstrate a high degree of correlation between the measurements with and without UCA with no evidence for a systematic effect arising from the use of UCA. When comparing the measurements of two independent investigators, the use of UCA rather leads to a higher variability than to an improved precision.DiscussionDespite the fact that the use of UCA during TOE leads to an improved rule out of thrombi, our study shows that there is no advantageous effect of UCA on the size determination of the LAA and should therefore not be used for this purpose.

Left atrial appendage morphology and relative contrast agent concentration in patients undergoing coronary artery CTA

2018 ◽  
Vol 73 (11) ◽  
pp. 982.e17-982.e26 ◽  
Author(s):  
M. Korhonen ◽  
P. Mustonen ◽  
M. Hedman ◽  
J. Vienonen ◽  
J. Onatsu ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Contrast Agent ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Contrast Agent Concentration ◽  
Relative Contrast

scholarly journals Post-angiography Retention of the Contrast Agent in the Left Atrial Appendage Is Associated With Risk of Cardioembolic Stroke in Patients With Atrial Fibrillation: A Retrospective Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Ping Fang ◽  
Youquan Wei ◽  
Jinfeng Wang ◽  
Xianghai Wang ◽  
Hao Yang
Keyword(s):  
Atrial Fibrillation ◽  
Retrospective Study ◽  
Contrast Agent ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Relative Proportion ◽  
Multivariate Logistic Regression Analysis ◽  
Atrial Appendage ◽  
Cardioembolic Stroke ◽  
Stroke Group

Background: Atrial fibrillation (AF) represents an important risk factor for cardioembolic stroke, and most atrial thrombi originate from the left atrial appendage (LAA). Although the CHA2DS2-VASc score is widely used to estimate the risk of cardioembolic stroke in AF patients, yet greatly affected by many factors. This study was undertaken to determine the association between contrast agent retention in LAA after LAA angiography and risks of cardioembolic stroke in patients with AF.Methods: This is a retrospective study. The demographic and clinical data of AF patients undergone left atrial appendage occlusion (LAAO) with or without catheter radiofrequency ablation were retrospectively analyzed. The patients were classified into either stroke or non-stroke group by the history with cardioembolic stroke or transient ischemic attack (TIA).Results: Sixty-two consecutive patients undergone LAAO were finally included, in whom 31 AF patients had a history of cardioembolic stroke or TIA (one TIA), and significantly higher CHA2DS2-VASc score (4.2 ± 1.4 vs. 3.3 ± 1.3; P = 0.006) as well as incidence of contrast agent retention in LAA (n = 20 vs. n = 7; P = 0.001) compared to the patients in non-stroke group. In addition, the relative proportion of distinctive morphological types of LAA was significantly different between groups (P < 0.001). Multivariate logistic regression analysis showed that higher CHA2DS2-VASc scores (OR = 1.7, 95% CI: 1.0–3.0, P = 0.046) and LAA contrast agent retention (OR = 5.1, 95% CI: 1.1–23.9, P = 0.002) were associated with increased risks of cardioembolic stroke. The patients with Windsock type LAA (OR = 7.8, 95% CI: 1.1–57.2, P = 0.044) and Cauliflower LAA (OR = 20.2, 95% CI: 3.2–125.5, P = 0.001) were more prone to cardioembolic stroke compared to those with Chicken Wing type LAA.Conclusion: Left atrial appendage contrast agent retention after LAA angiography is associated with the risks of cardioembolic stroke in patients with AF, and cardioembolic stroke is more seen in AF patients with Windsock or Cauliflower type LAA.

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