Reference value of perimeter‐derived diameter assessed by three‐dimensional transesophageal echocardiography in left atrial appendage occluder size selection

Kong, Dehong; Zhang, Xiaochun; Jin, Qinchun; Dong, Lili; Zhou, Daxin; Shu, Xianhong; Pan, Cuizhen

doi:10.1111/echo.14705

Cited by 2 publications

(2 citation statements)

References 26 publications

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“…For patients with flat oval type whose longest diameter significantly exceeds the shortest diameter, selecting the Watchman occluder device with proximal round shape simply according to the longest diameter may result in the selection of too large occluder and the risk of LAA tear. It has been demonstrated that the landing zone perimeter can better predict the optimal occluder size because the length diameter and short diameter of landing zone ostium will change and the ostium will change to a circular shape after occluder implantation, whereas the perimeter often remains unchanged (20)(21)(22). However, in the aforementioned studies, the landing zone was located using the conventional method, which has the drawback of providing an erroneous assessment of the landing zone.…”

Section: Discussionmentioning

confidence: 99%

The effect of two different methods of planning landing zone for left atrial appendage closure by cardiac computed tomography angiography: a comparative study

Li¹,

Zhang²,

Ruan³

et al. 2023

Ann Transl Med

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Background To explore the value of 2 different methods for planning landing zone for left atrial appendage closure (LAAC) by cardiac computed tomography angiography (CCTA). Methods A retrospective analysis was performed on the clinical data of patients who successfully underwent LAAC with the Watchman device at The Affiliated Taizhou People’s Hospital of Nanjing Medical University from August 2020 to February 2022. Two different methods were used to plan the landing zone and measure the longest diameter, average diameter, depth, and perimeter of the landing zone. The difference between the 2 methods and the correlation between their measurements and occluder size were analyzed. Results A total of 66 patients undergoing LAAC were included, with an average age of 69.35±7.1 years, of whom 30 (45.5%) were women. The mean error between the longest diameter measured by the traditional method and the actual value was 2.90±2.83 mm, and the mean absolute error (MAE) was 2.71 (1.17, 4.38) mm. The mean error between the longest diameter measured by the new method and the actual value was 0.9 (−0.13, 2.50) mm, and its MAE was 1.4 (0.40, 2.53) mm. The error of the longest diameter measured by the traditional method was larger than that measured by the new method (P<0.001). The mean error between the depth measured by the traditional method and the actual value was 1.40±3.45 mm, and the MAE was 2.36 (0.74, 4.58) mm. The mean error between the depth measured by the new method and the actual value was 0.10 (−1.33, 1.95) mm, and the MAE was 1.55 (0.60, 3.10) mm. Likewise, the depth error measured by the traditional method was larger than that measured by the new method (P<0.05). The correlation between the perimeter and the size of the occluder was the strongest (r=0.919, P<0.001). Conclusions With CCTA, the new method is more accurate in planning landing zone than the traditional method. It is particularly important to select the occluder size for the patients with flat oval landing zone ostium.

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Section: Discussionmentioning

confidence: 99%

The effect of two different methods of planning landing zone for left atrial appendage closure by cardiac computed tomography angiography: a comparative study

Li¹,

Zhang²,

Ruan³

et al. 2023

Ann Transl Med

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“…In a past study, Al-Kassou et al (2017) showed that using the diameter derived from the LZ area and LZ cir as a reference indicator for the occluder model is more relevant to the final choice of the occluder model. Kong et al also showed ( Kong et al, 2020 ) that the diameter derived from the LAA circumference is more suitable as a reference indicator for the occluder model because it is more stable compared to other indicators.…”

Section: Discussionmentioning

confidence: 99%

Real-time 3D echocardiographic transilluminated imaging combined with artificially intelligent left atrial appendage measurement for atrial fibrillation interventional procedures

Sun

Ren²,

Xiao³

et al. 2022

Front. Physiol.

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Aims: This study investigated the feasibility and accuracy of real-time three-dimensional (3D) echocardiographic transilluminated imaging (TrueVue Glass) in left atrial appendage (LAA) anatomical morphology and artificial intelligence (AI)-assisted 3D automated LAA measurement (3D Auto LAA) software in the preoperative evaluation of LAA occlusion (LAAO) in patients with atrial fibrillation (AF).Method and results: Thirty-seven patients with AF were selected. Two-dimensional (2D) and real-time 3D transesophageal echocardiography (RT3D-TEE) were performed preoperatively, using conventional 3D, the new 3D TrueVue Glass mode, and cardiac computed tomography angiography (CCTA) to assess and type the morphology of LAA. Physiological parameters were measured using traditional 2D and 3D manual (3D Manual LAA), 3D Auto LAA, and CCTA. TrueVue Glass for LAA outer contour display was compared with CCTA. Comparisons were based on correlation and consistency in measuring the maximum diameter (LZ max), minimum diameter (LZ min), area (LZ area), and circumference (LZ cir) of LAA landing zone (LZ). Times and variabilities were compared. The concordance rate for external shape of LAA was 97.14% between TrueVue Glass and CCTA. 3D Auto LAA and 3D Manual LAA have a stronger correlation and higher consistency in all parameters. 3D Auto LAA showed higher intra- and interobserver reproducibility and allowed quicker analysis (p < 0.05). LAAO was performed in 35 patients (94.59%), and none of which had serious adverse events.Conclusion: TrueVue Glass is the first non-invasive and radiation-free visualization of the overall external contour of LAA and its adjacent structures. 3D Auto LAA simplifies the measurement, making the preoperative assessment more efficient and convenient while ensuring the accuracy and reproducibility. A combination of the two is feasible for accurate and rapid assessment of LAA anatomy and physiology in AF patients and has practical application in LAAO.

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Reference value of perimeter‐derived diameter assessed by three‐dimensional transesophageal echocardiography in left atrial appendage occluder size selection

Cited by 2 publications

References 26 publications

The effect of two different methods of planning landing zone for left atrial appendage closure by cardiac computed tomography angiography: a comparative study

The effect of two different methods of planning landing zone for left atrial appendage closure by cardiac computed tomography angiography: a comparative study

Real-time 3D echocardiographic transilluminated imaging combined with artificially intelligent left atrial appendage measurement for atrial fibrillation interventional procedures

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