Quantitative CT predicts peri-device leak after left atrial appendage closure

Background To investigate whether quantitative CT anatomical structure parameters can predict peri-device leak (PDL) after left atrial appendage closure (LAAC). Methods The clinical history, preoperative, and postoperative CT angiography of 98 patients with LAAC were retrospectively analyzed. The patients were divided into complete closure group (65 cases) and PDL group (33 cases). The differences in clinical history and CT quantitative parameters between the two groups were compared by χ2 test or t test. A multivariate logistic regression analysis was performed to establish a CT model to analyze the risk factors affecting PDL. The receiver operating characteristic curve was used to predict and analyze the diagnostic efficacy of the model. Results T-test analysis of two independent samples showed that there were statistically significant differences in the preoperative longitudinal diameter, transverse diameter, area, and landing zone diameter of the LAA orifice between the two groups (all p < 0.05). Univariate and multivariate Logistic regression analysis showed that the preoperative LAA orifice longitudinal diameter was an independent risk factor for predicting PDL, where the AUC value of the ROC curve was 0.765, with a sensitivity of 87.9%, and a specificity of 52.3%. PDL was more likely to develop when the longitudinal diameter of preoperative LAA orifice was greater than 26.5 mm. Conclusion The incidence rate of PDL in this study was about 22.15%, CTA can objectively and quantitatively analyze PDL. The preoperative LAA orifice longitudinal diameter of LAA can be used as a sensitive method to predict PDL.