The correlation between left atrial appendage morphology and peri-device leak after thoracoscopic LAAL in patients with atrial fibrillation based on CCTA
Objective:To analyze the correlation between peri-device leak(PDL)after thoracoscopic left atrial appendage ligation(LAAL)in patients with atrial fibrillation(AF)and left atrial appendage(LAA)morphology based on postoperative cardiac computed tomography angiography(CCTA).Methods:Sixty-two patients with AF who underwent successful LAAL at the First Affiliated Hospital of Jinan University from November 2017 to April 2023 were enrolled,as well as their clinical data.Their postoperative CCTA images were evaluated to assess LAA morphological parameter.Based on the follow-up results after LAAL,the patients were divided into two groups,the PDL group(n=34)and the non-PDL group(n=28).Logistic regression analysis was performed to identify significant risk factors among the variables with statistical differences between the two groups.Results:The parameters of the LAA between two groups were included in the single factor logistic regression analysis.The results showed that the short diameter of LAA(OR=0.393,95%CI:0.167~0.926,P=0.033),the long diameter of LAAO(OR=0.330,95%CI:0.138~0.785,P=0.012),the short diameter of LAAO(OR=0.083,95%CI:0.019~0.367,P=0.001),the perimeter of LAAO(OR=0.078,95%CI:0.510~0.983,P=0.039),the area of LAAO(OR=0.499,95%CI:0.319~0.783,P=0.002),and the volume of LAA(OR=0.855,95%CI:0.768~0.953,P=0.005)were associated with the occurrence of PDL.After multivariate logistic regression correction,that LAAO short diameter becomes longer was a risk factor for the occurrence of PDL.Conclusion:The assessment of LAA morphology through CCTA has a certain predictive value for the occurrence of postoperative PDL in AF patients.When the short diameter of LAAO becomes longer,we need to be alert to the occurrence of PDL.