CT Imaging to Assess the Left Atrial Appendage Anatomy: Clinical Implications

Biase, Luigi Di; Horton, Rodney; Burkhardt, J. David

doi:10.5772/25008

Cited by 4 publications

(4 citation statements)

References 32 publications

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“…A round shape is present only in 5.7% of cases. Interestingly, ostium diameters showed minimal changes during different phases of the cardiac cycle in sinus rhythm (maximal change 1 to 2 mm), while no change was observed during AF [ 19 ].…”

Section: Physiology and Pathophysiology Of The Laamentioning

confidence: 99%

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Left Atrial Appendage: Physiology, Pathology, and Role as a Therapeutic Target

Regazzoli

Ancona

Trevisi

et al. 2015

BioMed Research International

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Atrial fibrillation (AF) is the most common clinically relevant cardiac arrhythmia. AF poses patients at increased risk of thromboembolism, in particular ischemic stroke. The CHADS2 and CHA2DS2-VASc scores are useful in the assessment of thromboembolic risk in nonvalvular AF and are utilized in decision-making about treatment with oral anticoagulation (OAC). However, OAC is underutilized due to poor patient compliance and contraindications, especially major bleedings. The Virchow triad synthesizes the pathogenesis of thrombogenesis in AF: endocardial dysfunction, abnormal blood stasis, and altered hemostasis. This is especially prominent in the left atrial appendage (LAA), where the low flow reaches its minimum. The LAA is the remnant of the embryonic left atrium, with a complex and variable morphology predisposing to stasis, especially during AF. In patients with nonvalvular AF, 90% of thrombi are located in the LAA. So, left atrial appendage occlusion could be an interesting and effective procedure in thromboembolism prevention in AF. After exclusion of LAA as an embolic source, the remaining risk of thromboembolism does not longer justify the use of oral anticoagulants. Various surgical and catheter-based methods have been developed to exclude the LAA. This paper reviews the physiological and pathophysiological role of the LAA and catheter-based methods of LAA exclusion.

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Section: Physiology and Pathophysiology Of The Laamentioning

confidence: 99%

“…Histologically, the LAA has a single layer of endothelium and contains pectinate muscles with variable thickness [ 19 ]. The anterolateral wall, close to the mitral valve, has the minimum thickness (0.5 mm): particular care should be taken to avoid perforation during invasive procedures.…”

Section: Physiology and Pathophysiology Of The Laamentioning

confidence: 99%

Left Atrial Appendage: Physiology, Pathology, and Role as a Therapeutic Target

Regazzoli

Ancona

Trevisi

et al. 2015

BioMed Research International

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“…Further, for the specific application of electrical isolation of the left atrial appendage, depth needs to be investigated and optimized for as the depth fluctuates around the left atrial appendage [25]. As part of this future work, electro-tissue contact also needs to be accounted for.…”

Section: Limitations Of the Study And Future Workmentioning

confidence: 99%

A Predictive and an Optimization Mathematical Model for Device Design in Cardiac Pulsed Field Ablation Using Design of Experiments

Dunne,

Baena-Montes,

Donaghey

et al. 2023

JCDD

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Cardiac catheter ablation (CCA) is a common method used to correct cardiac arrhythmia. Pulsed Field Ablation (PFA) is a recently-adapted CCA technology whose ablation is dependent on electrode and waveform parameters (factors). In this work, the use of the Design of Experiments (DoE) methodology is investigated for the design and optimization of a PFA device. The effects of the four factors (input voltage, electrode spacing, electrode width, and on-time) and their interactions are analyzed. An empirical model is formed to predict and optimize the ablation size responses. Based on the ranges tested, the significant factors were the input voltage, the electrode spacing, and the on time, which is in line with the literature. Two-factor interactions were found to be significant and need to be considered in the model. The resulting empirical model was found to predict ablation sizes with less than 2.1% error in the measured area and was used for optimization. The findings and the strong predictive model developed highlight that the DoE approach can be used to help determine PFA device design, to optimize for certain ablation zone sizes, and to help inform device design to tackle specific cardiac arrhythmias.

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“…18). In addition, LA appendage morphology, the angle of the LA appendage bending, and the diameter of the orifice can be accurately measured by MDCT (57).…”

Section: Multidetector Computerized Tomography (Mdct)mentioning

confidence: 99%

New Perspectives by Imaging Modalities for an Old Illness: Rheumatic Mitral Stenosis

2020

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New perspectives by imaging modalities for an old illness: Rheumatic mitral stenosisMitral stenosis (MS) is a progressive and devastating disease and most often occurs among young women. Given its considerable prevalence in Mediterranean and Eastern European countries according to the Euro Heart Survey, new imaging modalities are warranted to improve the management of patients with this condition. A wide spectrum of abnormalities occurs involving all parts of this complex structure and causing different grades of MS and/or regurgitation as a consequence of rheumatic affection. Novel imaging modalities significantly improved the assessment of several aspects of this rheumatic destructive process including the morphological alterations of the mitral valve (MV) apparatus, left atrial (LA) function, LA appendage, right and left ventricular (LV) functions, and complications, namely, atrial fibrillation and thromboembolic events. Furthermore, new imaging modalities improved the prediction of outcome of patients who underwent percutaneous balloon mitral comissurotomy and changed the paradigm of patient selection for intervention and risk stratification. The present review aimed to summarize the role of new multimodality, multiparametric imaging approaches to assess the morphological characteristics of the rheumatic MS and its associated complications, and to guide patient management. (Anatol J Cardiol 2020; 23: 128-40) ABSTRACT 128 # Authors contributed equally to the manuscript. Kemaloğlu Öz et al. Multimodality imaging for mitral stenosis Anatol

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CT Imaging to Assess the Left Atrial Appendage Anatomy: Clinical Implications

Cited by 4 publications

References 32 publications

Left Atrial Appendage: Physiology, Pathology, and Role as a Therapeutic Target

Left Atrial Appendage: Physiology, Pathology, and Role as a Therapeutic Target

A Predictive and an Optimization Mathematical Model for Device Design in Cardiac Pulsed Field Ablation Using Design of Experiments

New Perspectives by Imaging Modalities for an Old Illness: Rheumatic Mitral Stenosis

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