The value of transesophageal echocardiography and computer tomography angiography in selection of the size of left atrial appendage occluder
Objective To investigate the application value of computed tomography angiography(CTA)and transesophageal echocar-diography(TEE)in the selection of occluder models before left atrial appendage occluder.Methods The clinical data of 215 patients with nonvalvular atrial fibrillation who underwent preoperative CTA and TEE examination,intraoperative left atrial appendage angiogra-phy(LAA-A)examination,and left auricular occlusion with Watchman occlusive device or LAmbre occlusive device from January 2020 to December 2021 in General Hospital of Northern Theater Command were retrospectively analyzed.The gold standard for assessing LAA size was the LAA-A during the procedure.The intraclass correlation coefficient(ICC)analysis was utilized to examine the consis-tency of CTA,TEE,and LAA-A in measuring left atrial appendage size.Results In the Watchman group,the diameter of LAA landing zone measured by TEE was consistent with that measured by LAA-A,and the ICC value was 0.862(P<0.001).The diameter of LAA landing zone measured by CTA was consistent with that measured by LAA-A,and the ICC value was 0.955(P<0.001).However,the diameter of LAA depth zone measured by TEE was not consistent with that measured by LAA-A,the ICC value was 0.363(P<0.001).The diameter of LAA depth zone measured by CTA was not consistent with that measured by LAA-A,the ICC value was 0.377(P<0.001).In the LAmbre device,the diameter of LAA orifice measured by TEE was consistent with that measured by LAA-A,and the ICC value was 0.801(P<0.001).The diameter of LAA orifice measured by CTA was consistent with that measured by LAA-A,and the ICC value was 0.965(P<0.001).The diameter of the landing zone measured by TEE was also consistent with that measured by LAA-A,and the ICC value was 0.792(P<0.001).The diameter of the landing zone measured by CTA was consistent with that measured by LAA-A,and the ICC value was 0.934(P<0.001).Conclusion In the Watchman occluded device,TEE,CTA and LAA-A had good consistency in the diameter of the landing zone,but the left atrial appendage depth measured by the two imaging methods had poor consistency with that measured by LAA-A.In LAmbre occluder,TEE,CTA and LAA-A measured port diameter and landing area diameter are consistent,which can be used to guide the selection of occluder type.
NETL
NSTL
万方数据
