Key result
TEE detects 4 small LAA thrombi missed by TTE and CT.
Why the study?
The detection of intracardiac thrombi in patients with cardioembolic stroke and underlying heart disease requires evaluation of the diagnostic performance of transesophageal echocardiography compared to other imaging methods.
Does transesophageal echocardiography improve the detection of intracardiac thrombi compared to transthoracic echocardiography and computed tomography in patients with cardioembolic stroke?
Observational (n=56)
Does transesophageal echocardiography improve the detection of intracardiac thrombi compared to transthoracic echocardiography and computed tomography in patients with cardioembolic stroke?
Transesophageal echocardiography is superior to transthoracic echocardiography and ultrafast computed tomography for detecting small intracardiac thrombi, particularly in the left atrial appendage, in patients with cardioembolic stroke.
May enhance small LAA thrombus detection in cardioembolic stroke; leaves open impact on management and outcomes.
The authors studied 56 patients with cardioembolic stroke to search for intracardiac thrombi by use of transesophageal and transthoracic echocardiography. Forty consecutive patients were examined within four weeks of stroke onset and the remaining 16 in the chronic stage. They also performed ultrafast computed tomography in 9 of them. Underlying heart disease was present in all subjects. Anticoagulant therapy had already been started in 29 at the time of examinations. Using their own criteria for echocardiography, they diagnosed intracardiac thrombus in 7 cases and valvular vegetation in 1. Six thrombi were located in the left atrial appendage, 4 of which were smaller than 10 mm in diameter. These small thrombi were not found by either transthoracic echocardiography or computed tomography. Transesophageal echocardiography appears to be superior to the other two methods, especially for detecting small intracardiac thrombi in the left atrial appendage.
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Toyoda et al. (1993) conducted an observational in Cardioembolic stroke (n=56). Transesophageal echocardiography vs. Transthoracic echocardiography and computed tomography was evaluated on Detection of intracardiac thrombi. Transesophageal echocardiography detected intracardiac thrombi in 7 of 56 patients, including 4 small left atrial appendage thrombi missed by transthoracic echocardiography and computed tomography.
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