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Assessment of Left Atrial Appendage Structure and Function by Transesophageal Echocardiography: A Review
Siu-Sun Yao1, Jay S. Meisner, Stephen M. Factor
1Division of Cardiology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Forchheimer Building, Room G-42, Bronx, New York 10461 shirani@aecom.yu.edu
Insights
Transesophageal echocardiography (TEE) is crucial for evaluating the left atrial appendage in various heart conditions. This review highlights TEE
Area of Science:
- Cardiology
- Medical Imaging
Background:
- The left atrial appendage (LAA) plays a significant role in cardiovascular health, particularly in conditions like atrial fibrillation.
- Accurate assessment of LAA anatomy and function is vital for managing thromboembolic risk.
- Transesophageal echocardiography (TEE) is a key imaging modality for LAA evaluation.
Purpose of the Study:
- To review the utility of TEE in assessing LAA anatomy and function.
- To summarize TEE's role in patients with atrial fibrillation, cardioembolism, or mitral stenosis.
- To discuss TEE's application in cardioversion and percutaneous mitral stenosis interventions.
Main Methods:
- Comprehensive literature review of studies utilizing TEE for LAA assessment.
- Analysis of data regarding TEE's effectiveness in specific patient populations.
- Evaluation of current limitations and future directions in TEE for LAA.
Main Results:
- TEE provides detailed anatomical and functional insights into the LAA.
- TEE is valuable in predicting cardioembolic risk in atrial fibrillation.
- TEE aids in guiding interventions for atrial fibrillation and mitral stenosis.
Conclusions:
- TEE is an indispensable tool for LAA evaluation in diverse cardiac conditions.
- Standardized reporting of quantitative TEE data is recommended for consistency.
- Ongoing advancements promise enhanced TEE capabilities for LAA assessment.
Abstract:
This article examines the transesophageal echocardiographic assessment of the left atrial appendage anatomy and function in individuals without significant structural heart disease and in those with atrial fibrillation with or without cardioembolism or mitral valve stenosis. We also summarize the available data in the usefulness of transesophageal echocardiographic studies in patients undergoing cardioversion for atrial fibrillation and percutaneous balloon valvuloplasty for mitral stenosis. Also, potential limitations and ongoing developments in the use of transesophageal echocardiography in the assessment of the left atrial appendage are outlined, and recommendations are given for the uniform reporting of quantitative data.