scholarly journals Evaluation of endothelialization of left atrial appendage occluder by three-dimensional transesophageal echocardiography and its influence factors

2020 ◽  
Author(s):  
Lihong Wang ◽  
Hongyue Mao ◽  
Lei Shi ◽  
Hongyan Li ◽  
Guifang Song
Keyword(s):  
Risk Factors ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Thrombotic Event ◽  
Three Dimensional ◽  
Influence Factors ◽  
Left Ventricular ◽  
Atrial Appendage ◽  
Spontaneous Echo Contrast ◽  
Three Dimensional Echocardiography

Abstract Background This study evaluated surface endothelialization of Watchman occluder (Boston Scientific) through comparing relevant indicators before and left atrial appendage closure (LAAC) in 68 non-valvular atrial fibrillation (AF) patients.Methods Patients were monitored preoperatively by transthoracic echocardiography (TTE), transesophageal two-dimensional and three-dimensional echocardiography (2D-TEE, 3D-TEE), intraoperatively by 3D-TEE and angiocardiography, and followed at 3 and 6 months after operation by TEE.Result It showed that the inner diameters of LAA ostium measured by TEE at 0°, 90° and 135° before operation were correlated with corresponding maximum diameters measured by angiocardiography. The depth of LAA ostium measured at 90° was correlated with the maximum depth measured by angiocardiography. The left atrial diameter, left ventricular diameter and left ventricular free wall E/E' decreased postoperatively. Compared T-test showed that BNP level and persistent AF might be risk factors for spontaneous echo contrast (SEC) or thrombosis of LAA. Multiple linear regression identified persistent AF, preoperative LAA spontaneous echo contrast or recent thrombotic event, and history of embolism in other parts were the influence factors of occluder endothelialization.Conclusion: BNP level and persistent AF may be risk factors of left atrial appendage thrombosis. Treatment of AF and thrombus in left atrial appendage or other parts are beneficial to the prognosis of LAAC patients.

Real-Time Three-Dimensional Echocardiography for Left Atrial Appendage Ligation

2009 ◽  
Vol 108 (5) ◽  
pp. 1467-1469 ◽  
Author(s):  
Robina Matyal ◽  
Swaminathan Karthik ◽  
Balachundhar Subramaniam ◽  
Peter Panzica ◽  
Sugantha Sundar ◽  
...  
Keyword(s):  
Real Time ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Three Dimensional ◽  
Atrial Appendage ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography

scholarly journals Three-Dimensional Echocardiography of Left Atrial Appendage Thrombus

2001 ◽  
Vol 18 (2) ◽  
pp. 163-166 ◽  
Author(s):  
Gazala N. Khan ◽  
Ismail T. Dairywala ◽  
Zheng Liu ◽  
Peng Li ◽  
Jim Carroll ◽  
...  
Keyword(s):  
Left Atrial ◽  
Left Atrial Appendage ◽  
Three Dimensional ◽  
Atrial Appendage ◽  
Left Atrial Appendage Thrombus ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography

scholarly journals Left Ventricular Ejection Fraction Is Associated with the Risk of Thrombus in the Left Atrial Appendage in Patients with Atrial Fibrillation

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Beata Uziębło-Życzkowska ◽  
Paweł Krzesiński ◽  
Agnieszka Jurek ◽  
Agnieszka Kapłon-Cieślicka ◽  
Iwona Gorczyca ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Left Ventricular ◽  
Atrial Appendage ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

Introduction. Atrial fibrillation (AF) is associated with high risk of ischemic stroke. The most frequent thrombus location in AF is the left atrial appendage (LAA). Transthoracic echocardiography (TTE) is a basic diagnostic examination in patients (pts) with AF. Objectives. To analyse the relations between basic echocardiographic features, well-established stroke risk factors, type of AF, and anticoagulation therapy with the incidence of left atrial appendage thrombus (LAAT). Patients and Methods. The study group consisted of 768 pts with AF (mean age, 63 years), admitted to three high-reference cardiology departments. Five hundred and twenty-three pts were treated with non-vitamin K antagonist oral anticoagulants (NOACs) and 227 (30%) with vitamin K antagonists (VKAs). The subjects underwent TTE and transesophageal echocardiography (TEE) before cardioversion or ablation. Results. LAAT was significantly more frequent in pts with reduced left ventricular ejection fraction (LVEF): in 10.6% (7 pts) with LVEF<40% and in 9.0% (9 pts) with LVEF 40-49%, while only in 5.5% (33 pts) with LVEF>50%. Compared to pts without LAAT, those with LAAT presented with lower LVEF and higher left atrial diameter (LAD). Multivariate logistic regression revealed the following variables as independent predictors of LAAT: previous bleeding, treatment with VKA, and LVEF. Conclusion. LAAT is related to lower LVEF and higher LAD. LVEF is one of the independent predictors of LAAT. Even in the case of adequate anticoagulant therapy, it might be prudent to consider TEE before cardioversion or ablation in patients with low LVEF and LA enlargement, especially in the coexistence of other thromboembolic risk factors.

scholarly journals Predictors of spontaneous echo contrast and left atrial appendage thrombosis in nonvalvular atrial fibrillation

2020 ◽  
Vol 25 (7) ◽  
pp. 3765
Author(s):  
N. Yu. Khorkova ◽  
T. P. Gizatulina ◽  
A. V. Belokurova ◽  
E. A. Gorbatenko
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Left Ventricular ◽  
Atrial Appendage ◽  
Nonvalvular Atrial Fibrillation ◽  
Spontaneous Echo Contrast ◽  
Obese Class ◽  
Group 2 ◽  
Group 1

Aim. To identify predictors of spontaneous echo contrast (SEC) and/or left atrial appendage (LAA) thrombosis in patients with nonvalvular atrial fibrillation (AF) who are referred for elective cardioversion or catheter ablation (CA).Material and methods. A retrospective analysis of data from 638 patients with nonvalvular AF who were hospitalized from 2014 to 2017 for cardioversion or CA was performed. All patients underwent diagnostic tests, including transthoracic and transesophageal echocardiography (TEE).Results. According to the TEE results, two groups of patients were formed: group 1 — 95 patients (14,9%) with signs of SEC and/or thrombosis in LAA; group 2 — 543 patients (85,1%) without SEC or thrombosis in LAA. Patients with the phenomenon of SEC and/or LAA thrombosis were older, had a higher risk on the CHA2DS2-VASc score. These patients were more likely to have coronary heart disease (CAD), hypertension, stage IIA chronic heart failure, obese class >II, persistent or permanent AF Patients in both groups did not differ in anticoagulant therapy. Patients in group 1 had a larger size of the left and right atria, right ventricle, left ventricular (LV) end-systolic and end-diastolic diameters, higher LV mass index, lower values of LV ejection fraction and blood flow velocity in LAA. Logistic regression revealed following independent predictors of SEC and/or LAA thrombosis: CAD (odds ratio (OR) 2,289; 95% confidence interval (CI) 1,313-3,990; p=0,003), persistent or permanent AF (OR 2,071; 95% CI 1,222-3,510; p=0,007), LA diameter >43 mm (OR 3,569; 95% CI 2,0822-6,117; p<0,001), concentric or eccentric LV hypertrophy (OR 2,230; 95% CI 1,302-3,819; p=0,003).Conclusion. As the result, all patients referring for CA or cardioversion, regardless of the CHA2DS2-VASc score, should underwent LAA. According to this study, the presence of CAD, persistent or permanent AF, LA diameter >43 mm, concentric or eccentric LV hypertrophy are independent predictors of SEC and/or LAA thrombosis.

scholarly journals 1113-161 Assessment of the left atrial appendage using transthoracic real-time three-dimensional echocardiography

2004 ◽  
Vol 43 (5) ◽  
pp. A345
Author(s):  
Eugene Shteerman ◽  
Kumiko Hirata ◽  
Om Kapoor ◽  
Marie-Edouard N Desvarieux ◽  
Todd Pulerwitz ◽  
...  
Keyword(s):  
Real Time ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Three Dimensional ◽  
Atrial Appendage ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography
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