Key result
3D-TEE and cardiac CT show excellent agreement for LAA landing zone diameter and depth.
Why the study?
Percutaneous left atrial appendage closure requires accurate measurements, but standardized approaches in measurement methods across different imaging modalities are lacking.
Does 3D TOE and CCT provide comparable and highly correlated measurements of the left atrial appendage landing zone compared to 2D TOE and CCA in patients undergoing LAAC?
Cross-Sectional (n=200)
Does 3D TOE and CCT provide comparable and highly correlated measurements of the left atrial appendage landing zone compared to 2D TOE and CCA in patients undergoing LAAC?
Effect estimate: r = 0.87 for LZ diameter; r = 0.91 for LAA depth
p-value: p=<0.001
3D TOE and CCT provide highly correlated measurements of the left atrial appendage landing zone, supporting their use for accurate device sizing in LAAC procedures.
May support 3D TOE or CCT interchangeably for LAA landing zone sizing; leaves open whether either improves LAAC outcomes versus 2D imaging.
Background: Percutaneous left atrial appendage closure (LAAC) requires accurate pre- and intraprocedural measurements, and multimodality imaging is an essential tool for guiding the procedure. Two-dimensional (2D TOE) and three-dimensional (3D TOE) transoesophageal echocardiography, cardiac computed tomography (CCT), and conventional cardiac angiography (CCA) are commonly used to evaluate left atrial appendage (LAA) size. However, standardized approaches in measurement methods by different imaging modalities are lacking. The aims of the study were to evaluate the LAA dimension and morphology in patients undergoing LAAC and to compare data obtained by different imaging modalities: 2D and 3D TOE, CCT, and CCA. Methods: A total of 200 patients (mean age 70 ± 8 years, 128 males) were examined by different imaging techniques (161 2D TOE, 103 3D TOE, 98 CCT, and 200 CCA). Patients underwent preoperative CCT and intraoperative 2D and 3D TOE and CCA. Results: A significant correlation was found among all measurements obtained by different modalities. In particular, 3D TOE and CCT measurements were highly correlated with an excellent agreement for the landing zone (LZ) dimensions (LZ diameter: r = 0.87; LAA depth: r = 0.91, p < 0.001). Conclusions: Head-to-head comparison among imaging techniques (2D and 3D TOE, CCT, and CCA) showed a good correlation among LZ diameter measurements obtained by different imaging modalities, which is a parameter of paramount importance for the choice of the LAAC device size. LZ diameters and area by 3D TOE had the best correlation with CCT.
No takes yet. Share an insight, caveat, or question.
Italiano et al. (2020) conducted a cross-sectional in Patients undergoing percutaneous left atrial appendage closure (LAAC) (n=200). Multimodality imaging (2D and 3D TOE, CCT, and CCA) was evaluated on Correlation among landing zone (LZ) dimensions obtained by different imaging modalities (r = 0.87 for LZ diameter; r = 0.91 for LAA depth, p=<0.001). Three-dimensional transoesophageal echocardiography and cardiac computed tomography showed excellent agreement for left atrial appendage landing zone diameter (r=0.87) and depth (r=0.91, p<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: