Evaluation of the left atrial appendage by real time three‐dimensional transesophageal echocardiography online

Zhang, Juan; Cui, Cunying; Huang, Dingming; Liu, Yuanyuan; Qin, Yue; Zhang, Lianzhong; Liu, Lin

doi:10.1111/echo.13870

Cited by 7 publications

(9 citation statements)

References 29 publications

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“…Incremental benefit of three-dimensional transthoracic echocardiography in the assessment of left atrial appendage aneurysm leading to severe extrinsic compression of a coronary artery in the proximal left anterior descending coronary artery (LAD) (Table 3). [13][14][15][16][17] In our case, 2DTTE was useful in the diagnosis of LAA AN. It also demonstrated severe LAD narrowing which could explain the pa- Localized outpouching or marked enlargement of LAA.…”

Section: R E S E a R C H F R O M O R I N C O L L A B O R A T I O N W mentioning

confidence: 49%

“…LAA AN size by echo (adult) has varied from 2.2 × 1.1 cm to 13 × 10 cm, and its opening from 1.7 cm to 3.5 cm. 1,7,13,[18][19][20][21] Suggestion: Diagnose LAA AN if LAA length, width and orifice measure more than 6.75 cm, 4.8 cm and 2.7 cm, respectively, which are 1.5-fold increase of LAA normal autopsy measurements. 1 Classifications • According to etiology:…”

Section: R E S E a R C H F R O M O R I N C O L L A B O R A T I O N W mentioning

confidence: 99%

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Incremental benefit of three‐dimensional transthoracic echocardiography in the assessment of left atrial appendage aneurysm leading to severe extrinsic compression of a coronary artery

et al. 2018

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Left atrial appendage aneurysm (LAA AN) is a rare disease entity, which can be congenital or acquired in nature. We report an adult patient with LAA AN presenting with anginal chest pain in whom live/real time three-dimensional transthoracic echocardiography (3DTTE) provided incremental value over the two-dimensional (2D) technique in providing a more comprehensive assessment of the lesion. A literature review of the salient features of LAA AN is also provided in a tabular form.

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Section: R E S E a R C H F R O M O R I N C O L L A B O R A T I O N W mentioning

confidence: 49%

Section: R E S E a R C H F R O M O R I N C O L L A B O R A T I O N W mentioning

confidence: 99%

Incremental benefit of three‐dimensional transthoracic echocardiography in the assessment of left atrial appendage aneurysm leading to severe extrinsic compression of a coronary artery

et al. 2018

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“…The symptoms often begin after the second decade, and the most common presenting symptoms are atrial arrhythmias as atrial fibrillation and flutter, 8 although thromboembolic events and supraventricular arrhythmias are also commonly reported. [2][3][4][5][6][7] Thrombus formation has been reported in the aneurysm in one-third of patients with congenital left atrial appendage aneurysm, 8 which may cause episodes of chest pain as a result of the compression of the left coronary artery and its branches. 9 The risk of complications is reported to increase in parallel to the size of the aneurysm.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] The most common complications are thromboe m b o l i c e v e n t s a n d s u p r a v e n t r i c u l a r tachyarrhythmias. 1,4,5 This condition is usually asymptomatic until the second or third decade of life. 1,2,4,6 We report a rare case of asymptomatic congenital giant aneurysm of the left atrial appendage, leading to left ventricular compression and moderate-severe mitral valve regurgitation.…”

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confidence: 99%

Asymptomatic giant congenital left atrial aneurysm

Yakut¹,

Varan²,

Erdoğan³

2019

Turk J Pediatr

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Congenital aneurysm of the left atrial appendage can be caused by congenital dysplasia of the pectinate muscles and may be accompanied by a congenital absence of the pericardium. Symptoms generally manifest after two decades and the most common symptom is atrial arrhythmia in the form of atrial fibrillation / flutter. A four year-old patient with no symptoms underwent an echocardiographic examination for the investigation of a heart murmur. Echocardiographic examination revealed a large cystic lesion occupying the left hemithorax and compressing the left ventricle. The patient was referred to our center. The lesion caused displacement of the heart rightward behind the sternum which made the examination difficult. We aimed to present this rare case of giant left atrial appendage aneurysm in the light of current literature.

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“…Before or upon transseptal puncture, heparin is administered intravenously to achieve a target of active clotting time (ACT) >250 s [ 17 ]. TEE allows to exclude presence of thrombotic formations in LAA, to guide the transseptal puncture and, finally, to verify the correct position of the device and the presence of peri-device leaks [ 31 ] as shown in Figure 1 . Several meta-analysis have assessed successes and complications of this procedure.…”

Section: Percutaneous Laao Proceduresmentioning

confidence: 99%

Percutaneous Left Atrial Appendage Occlusion: An Emerging Option in Patients with Atrial Fibrillation at High Risk of Bleeding

et al. 2021

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Atrial fibrillation (AF) is a common cardiac arrhythmia with an estimated prevalence of 1% in the general population. It is associated with an increased risk of ischemic stroke, silent cerebral ischemia, and cognitive impairment. Due to the blood flow stasis and morphology, thrombus formation occurs mainly in the left atrial appendage (LAA), particularly in the setting of nonvalvular AF (NVAF). Previous studies have shown that >90% of emboli related to NVAF originate from the LAA, thus prevention of systemic cardioembolism is indicated. According to the current guidelines, anticoagulant therapy with direct oral anticoagulants (DOACs) or vitamin K antagonists (VKAs), represents the standard of care in AF patients, in order to prevent ischemic stroke and peripheral embolization. Although these drugs are widely used and DOACs have shown, compared to VKAs, non-inferiority for stroke prevention with significantly fewer bleeding complications, some issues remain a matter of debate, including contraindications, side effects, and adherence. An increasing number of patients, indeed, because of high bleeding risk or after experiencing life-threatening bleedings, must take anticoagulants with extreme caution if not contraindicated. While surgical closure or exclusion of LAA has been historically used in patients with AF with contradictory results, in the recent years, a novel procedure has emerged to prevent the cardioembolic stroke in these patients: The percutaneous left atrial appendage occlusion (LAAO). Different devices have been developed in recent years, though not all of them are approved in Europe and some are still under clinical investigation. Currently available devices have shown a significant decrease in bleeding risk while maintaining efficacy in preventing thromboembolism. The procedure can be performed percutaneously through the femoral vein access, under general anesthesia. A transseptal puncture is required to access left atrium and is guided by transesophageal echocardiography (TEE). Evidence from the current literature indicates that percutaneous LAAO represents a safe alternative for those patients with contraindications for long-term oral anticoagulation. This review summarizes scientific evidences regarding LAAO for stroke prevention including clinical indications and an adequate patient selection.

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Evaluation of the left atrial appendage by real time three‐dimensional transesophageal echocardiography online

Abstract: Using online RT3DTEE for measuring LAA orifice size is feasible, and online RT3DTEE is more convenient than offline RT3DTEE. EF is positively correlated with PEV. LAA function is significantly decreased in patients with AF.

Cited by 7 publications

References 29 publications

Incremental benefit of three‐dimensional transthoracic echocardiography in the assessment of left atrial appendage aneurysm leading to severe extrinsic compression of a coronary artery

Incremental benefit of three‐dimensional transthoracic echocardiography in the assessment of left atrial appendage aneurysm leading to severe extrinsic compression of a coronary artery

Asymptomatic giant congenital left atrial aneurysm

Percutaneous Left Atrial Appendage Occlusion: An Emerging Option in Patients with Atrial Fibrillation at High Risk of Bleeding

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