Key result
Transesophageal echocardiography measurements of maximal LAA orifice diameter and depth strongly correlated with digital subtraction angiography (r=0.75 and r=0.82, respectively; P<0.001).
Why the study?
The study was conducted to evaluate the use of transesophogeal echocardiography for percutaneous left atrial appendage occlusion.
Does transesophageal echocardiography accurately measure LAA dimensions and effectively guide percutaneous LAA occlusion compared to digital subtraction angiography in patients with non-valvular AF?
Observational (n=20)
Does transesophageal echocardiography accurately measure LAA dimensions and effectively guide percutaneous LAA occlusion compared to digital subtraction angiography in patients with non-valvular AF?
Effect estimate: r = 0.75 and r = 0.82
p-value: p=< 0.001
TEE provides accurate preoperative measurements of LAA dimensions that strongly correlate with DSA, and effectively guides percutaneous LAA occlusion.
Supports TEE-guided LAA occlusion in select cases; leaves open prospective validation versus DSA.
Objective: To evaluate the use of transesophogeal echocardiography (TEE) for percutaneous left atrial appendage (LAA) occlusion. Methods: LAA occlusion was performed in 20 atrial fibrillation (AF) patients with non-valvular lesions, including nine males and 11 females. TEE was used for the preoperative measurement of the maximal LAA orifice diameter and LAA depth and the guidance of atrial septum puncture. The release of the occluder during the occlusion procedure was also performed under TEE monitoring. Results: All 20 patients underwent successful occlusion of the LAA under the guidance of TEE. There were two (10.0%) cases with mild residual shunt after occlusion, among which only one (5.0%) patient still retained slight residual shunt at one month postoperative. All the other (95.0%) patients revealed no residual shunt. There was no difference between the maximal LAA orifice diameter (22.75 ± 4.85 mm vs. 22.15 ± 4.23) and LAA depth (36.60 ± 5.51 vs. 35.00 ± 4.76) derived from TEE and the digital subtraction angiography (DSA) measurement. Both the max orifice diameter and LAA depth measured by TEE were strongly correlated with that measured by DSA, with r = 0.75, P < 0.001 and r = 0.82, P < 0.001, respectively. Conclusions: TEE can accurately estimate the maximal LAA orifice diameter and LAA depth and provide an important reference for preoperative occluder size selection. It can also be used for intraoperative guidance and assessing results during the operation. TEE is of great importance for LAA occlusion.
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Huang et al. (2020) conducted an observational in Atrial fibrillation with non-valvular lesions (n=20). Transesophageal echocardiography (TEE) vs. Digital subtraction angiography (DSA) was evaluated on Correlation of maximal LAA orifice diameter and LAA depth between TEE and DSA (r = 0.75 and r = 0.82, p=< 0.001). Transesophageal echocardiography measurements of maximal LAA orifice diameter and depth strongly correlated with digital subtraction angiography (r=0.75 and r=0.82, respectively; P<0.001).
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