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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
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[Thrombo-embolic risk evaluation in patients with atrial fibrillation. Role of echocardiography]

S Carerj1, A Micari, S Di Rosa

  • 1Dipartimento Clinico-Sperimentale di Medicina e Farmacologia, Università degli Studi di Messina, Messina, Italy. scipione2@interfree.it

Minerva Cardioangiologica
|July 18, 2003
PubMed

Insights

Atrial fibrillation (AF) increases stroke risk. Transesophageal echocardiography (TEE) is crucial for detecting cardiac thrombi, enabling better risk assessment and prevention of thromboembolic events in AF patients.

Area of Science:

  • Cardiology
  • Medical Imaging

Background:

  • Atrial fibrillation (AF) is the most common cardiac arrhythmia.
  • AF is a primary cause of thromboembolic events, often originating from the left atrium or appendage.
  • Identifying high-risk patients is crucial for effective therapy and stroke prevention.

Purpose of the Study:

  • To evaluate the role of echocardiography in assessing thromboembolic risk in patients with AF.
  • To compare the diagnostic capabilities of Transthoracic Echocardiography (TTE) and Transesophageal Echocardiography (TEE) for thrombus detection.

Main Methods:

  • Review of clinical, laboratory, and echocardiographic data for risk stratification.
  • Comparison of Transthoracic Echocardiography (TTE) sensitivity (33-72%) versus Transesophageal Echocardiography (TEE) sensitivity (nearly 100%) for thrombus detection.

Main Results:

  • Transthoracic echocardiography (TTE) has limited sensitivity for detecting thrombi in posterior cardiac structures.
  • Transesophageal echocardiography (TEE) demonstrates high sensitivity (nearly 100%) in identifying cardiac thrombi.
  • Combined echocardiographic and clinical data improve risk stratification for thromboembolism.

Conclusions:

  • Transesophageal echocardiography (TEE) is essential for accurate thrombus detection in AF patients.
  • TEE is mandatory for effective thromboembolism prevention strategies in atrial fibrillation.
  • Multimodal risk stratification using TEE and clinical data optimizes patient management.

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