Key result
Preprocedural cardiac computed tomography in addition to 3D-transesophageal echocardiography did not reduce major adverse events compared to 3D-TEE alone in patients undergoing left atrial appendage closure.
Why the study?
Preprocedural imaging plays a crucial role in left atrial appendage closure, but the added value of combining cardiac computed tomography with 3D-TEE versus 3D-TEE alone needed evaluation.
Does preprocedural planning with cardiac computed tomography in addition to 3D-TEE reduce major adverse events or improve outcomes in patients undergoing left atrial appendage closure compared to 3D-TEE alone?
Cohort (n=343)
Does preprocedural planning with cardiac computed tomography in addition to 3D-TEE reduce major adverse events or improve outcomes in patients undergoing left atrial appendage closure compared to 3D-TEE alone?
Answers are grounded in this paper and cite their sources.
The routine addition of preprocedural cardiac CT to 3D-TEE does not significantly reduce major adverse events or improve procedural success in patients undergoing left atrial appendage closure.
Aim: Preprocedural imaging of the left atrial appendage (LAA) plays a crucial role in the process of LAA closure (LAAC). This study aimed to compare the influence of preprocedural planning of the LAAC with 3D-transesophageal echocardiography (TEE) and cardiac computed tomography (CCT) versus 3D-TEE alone in patients who underwent LAAC with an Amplatzer Cardiac Plug or Amulet. Materials and Methods: In a retrospective study, 176 patients received a preprocedural 3D-TEE and CCT and 167 patients a 3D-TEE only. Both groups had similar patient characteristics and indications for LAAC. Results: There was no difference in terms of procedural success, procedure time, amount of contrast medium, fluoroscopy time, or radiation dose. Patients with CCT/3D-TEE had a longer hospital stay on average. Besides, there was a different incidence of renal diseases (49% for 3D-TEE versus 27% for CCT/3D-TEE; p < 0.001). The number of periprocedural adverse events was comparable. A device-related thrombus occurred three times in each group, and the peri-device leaks reported were similar. Conclusion: A preprocedural CCT does not decrease major adverse events or improve outcome in patients undergoing LAAC.
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Heinrich et al. (2021) conducted a cohort in Atrial fibrillation with contraindication to oral anticoagulation (n=343). Preprocedural planning with Cardiac Computed Tomography (CCT) and 3D-Transesophageal Echocardiography (3D-TEE) vs. Preprocedural planning with 3D-TEE alone was evaluated on Major adverse events (MAEs) (p=0.15). Preprocedural cardiac computed tomography in addition to 3D-transesophageal echocardiography did not reduce major adverse events compared to 3D-TEE alone in patients undergoing left atrial appendage closure.
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