🫀 Mirza's Cardiology Notes

Left Atrial Appendage

2 min read

Echo of LAA

Emptying Velocities on TEE

CT of LAA

  • “Cardiac computed tomography, particularly when delayed imaging is performed, is a reliable alternative to TEE for the detection of LA/LAA thrombi/clot, avoiding the discomfort and risks associated with TEE.” 1
    • “In a subanalysis of studies in which delayed imaging was performed, the diagnostic accuracy significantly improved to a mean weighted sensitivity and specificity of 100% and 99%, respectively, whereas the positive predictive value and negative predictive value increased to 92% and 100%, respectively. The accuracy for this technique was 99%.”

Figure source: 2 - Axial image of a Cardiac CT Study Performed in a Patient Before RF Pulmonary Vein Ablation: (A) Initial image obtained after contrast injection demonstrates filling defect in the left atrial appendage tip. (B) Delayed image obtained 1 min after initial scan shows homogeneous opacification, suggesting an absence of thrombus.

Footnotes

  1. Romero J, Husain SA, Kelesidis I, Sanz J, Medina HM, Garcia MJ. Detection of left atrial appendage thrombus by cardiac computed tomography in patients with atrial fibrillation: a meta-analysis. Circ Cardiovasc Imaging. 2013 Mar 1;6(2):185-94. doi: 10.1161/CIRCIMAGING.112.000153. Epub 2013 Feb 13. PMID: 23406625. ↩

  2. Garcia MJ. Detection of Left Atrial Appendage Thrombus by Cardiac Computed Tomography. JACC: Cardiovascular Imaging. 2009;2(1):77-79. doi:10.1016/j.jcmg.2008.10.003 ↩

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