Accuracy of Commonly-Used Imaging Modalities in Assessing Left Atrial Appendage for Interventional Closure: Review...

Area of Science:

• Cardiology
• Medical Imaging
• Interventional Procedures

Background:

• Percutaneous Left Atrial Appendage (LAA) transcatheter occlusion requires precise imaging for procedural success.
• Accurate LAA dimensions are critical to avoid complications like device changes and prolonged procedures.
• Various imaging modalities, including CT, MRI, and ultrasound, are used for assessment.

Purpose of the Study:

• To evaluate the accuracy of commonly used imaging modalities for pre-procedural LAA assessment in transcatheter occlusion.
• To compare the diagnostic performance of different imaging techniques for LAA morphology.

Main Methods:

• A literature review was conducted using PubMed, retrieving 32 articles.
• The study analyzed the accuracy of 2D transesophageal echocardiography, 3D transesophageal echocardiography, CT, and 3D printing for LAA assessment.
• Institutional Review Board (IRB) approval was waived due to reliance on published data.

Main Results:

• Real-time 3D transesophageal echocardiography demonstrates higher accuracy than 2D transesophageal echocardiography for LAA measurements.
• 3D computed tomography, especially when combined with 3D printing, shows exceptional accuracy.
• 3D transesophageal echocardiography provides accurate measurements without radiation or contrast administration.

Conclusions:

• Real-time 3D transesophageal echocardiography is a highly accurate imaging modality for LAA assessment.
• 3D CT with 3D printing offers excellent accuracy, while 3D TEE is preferred for its safety profile.
• An algorithmic approach to LAA assessment across procedural phases will be presented.