Role of real time‑three dimensional transesophageal echocardiography in left atrial appendage closure with LACBES� devices

Zhang, Huili; Tang, Zhengde; Han, Zhihua; Zeng, Lefeng; Wang, Changqian

doi:10.3892/etm.2018.7086

Cited by 5 publications

(4 citation statements)

References 13 publications

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“…It has been discovered that changes in the ultrastructure of atrial myocytes and atrial fibrosis are the main forms of atrial remodeling in AF patients ( 29 , 30 ). Enlarged atrial myocardium not only affects atrial mechanical function but also increases the pathological basis for the formation of reentrant arrhythmias in AF, as the enlarged atrial myocardium can accommodate more reentrant wavelets ( 31 , 32 ). Research has found that inflammatory reactions are closely related to pathological processes such as electrical remodeling, structural remodeling and autonomic nervous system remodeling ( 33 , 34 ).…”

Section: Discussionmentioning

confidence: 99%

Predictive nomogram models for atrial fibrillation in COPD patients: A comprehensive analysis of risk factors and prognosis

Huang,

Cui

et al. 2024

Exp Ther Med

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The aim of the present study was to identify the independent risk factors and prognostic indicators for atrial fibrillation (AF) in patients with chronic obstructive pulmonary disease (COPD) and to develop predictive nomogram models. This retrospective study included a total of 286 patients with COPD who were admitted to the Second Affiliated Hospital of Guilin Medical College between January 2020 and May 2022. The average age of the patients was 77.11±8.67 years. Based on the presence or absence of AF, the patients were divided into two groups: The AF group (n=87) and the non-AF group (n=199). Logistic regression analysis was conducted to identify variables with significant differences between the two groups. Nomogram models were constructed to predict the occurrence of AF in COPD patients and to assess prognosis. Survival analysis was performed using the Kaplan-Meier method. The follow-up period for the present study extended until April 31, 2023. Survival time was defined as the duration from the date of the interview to the date the participant succumbed or the end of the follow-up period. In the present study, age, uric acid (UA) and left atrial diameter (LAD) were found to be independent risk factors for the development of AF in patients diagnosed with COPD. The stepwise logistic regression analysis revealed that age had an odds ratio (OR) of 1.072 [95% confidence interval (CI): 1.019-1.128; P=0.007], UA had an OR of 1.004 (95% CI: 1.001-1.008; P=0.010) and LAD had an OR of 1.195 (95% CI: 1.098-1.301; P<0.001). Univariate and multivariate Cox regression analysis revealed that LAD and UA were independent prognostic factors for long-term mortality in COPD patients with AF. LAD had a hazard ratio (HR) of 1.104 (95% CI: 1.046-1.165; P<0.001) and UA had an HR of 1.004 (95% CI: 1.000-1.008; P=0.042). Based on these findings, predictive nomogram models were developed for AF in COPD patients, which demonstrated good discrimination ability with an area under the curve of 0.886. The prognostic nomogram for COPD patients with AF also showed good predictive accuracy with a concordance index of 0.886 (95% CI: 0.842-0.930). These models can provide valuable information for risk assessment and prognosis evaluation in clinical practice. Age, UA and LAD are independent risk factors for AF in COPD patients. The developed nomogram models provide a reliable tool for predicting AF in COPD patients and for prognosis assessment.

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Section: Discussionmentioning

confidence: 99%

Predictive nomogram models for atrial fibrillation in COPD patients: A comprehensive analysis of risk factors and prognosis

Huang,

Cui

et al. 2024

Exp Ther Med

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“…A study of 137 patients demonstrated that 3D-TEE is more precise than 2D-TEE for the evaluation of LAA orifice size, with a strong correlation between 3D-TEE and CT measurements [47]. Another study of 22 patients undergoing LAA closure showed that 3D-TEE guidance performed during the interatrial septal puncture, the exchange of the sheath, and the release of the closure device was a reliable and effective imaging modality during this intervention [48]. In this last study, authors concluded that a full 3D-TEE view of the interatrial septum facilitated the determination of the optimal puncture site and avoided deformations of devices or significant residual leaks.…”

Section: Left Atrial Appendage Closurementioning

confidence: 99%

Three-Dimensional Transesophageal Echocardiography in Percutaneous Catheter-Based Cardiac Interventions

Farina,

Barry,

Arsanjani

et al. 2023

JCM

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Cardiac structural and valve interventions have remained surgical procedures for several decades. The ability to directly visualize the region of interest during surgery made imaging of these structures pre- and postsurgery a secondary tool to compliment surgical visualization. The last two decades, however, have seen rapid advances in catheter-based percutaneous structural heart interventions (SHIs). Due to the “blind” nature of these interventions, imaging plays a crucial role in the success of these procedures. Fluoroscopy is used universally in all percutaneous cardiac SHIs and helps primarily in the visualization of catheters and devices. However, success of these procedures requires visualization of intracardiac soft tissue structures. Due to its portable nature and rapid ability to show cardiac structures online, transesophageal echocardiography (TEE) has become an integral tool for guidance for all percutaneous SHI. Transcatheter aortic valve replacement—one of the earliest catheter-based procedures—while initially dependent on TEE, has largely been replaced by preprocedural cardiac CT for accurate assessment of valve sizing. Developments in echocardiography now allow live three-dimensional (3D) visualization of cardiac structures mimicking surgical anatomy during TEE. Besides showing actual 3D intracardiac structures, 3D-TEE allows visualization of the interaction of intracardiac catheters and devices with soft tissue cardiac structures, thereby becoming a “second pair of eyes” for the operator. Real-time 3D-TEE now plays an important role complementing multiplane two dimensional and biplane TEE during such interventions. In this review, we discuss the incremental role of 3D-TEE during various SHIs performed today.

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“…The PLAAO surgeries guided only by TEE or intracardiac echocardiography have been reported successfully in other medical centers [27][28][29]. In previous studies of other medical centers, the average time of PLAAO procedure guided by fluoroscopy and TEE or fluoroscopy-alone approach was 54.55 ± 8.30 min or 45.86 ± 7.83 min30 ; the duration of PLAAO procedure guided by fluoroscopy and real time 3D-TEE was 77.92 ± 21.96 min 31. All the PLAAO surgeries guided only by TEE in our study were performed successfully.…”

mentioning

confidence: 99%

Clinical application of percutaneous left atrial appendage occlusion guided only by transesophageal echocardiography without fluoroscopy and angiography in the patients with nonvalvular atrial fibrillation

Huang

Chen

Liu

et al. 2022

Journal of Cardiac Surgery

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Background and Aim: The objective of this study was to understand the clinical efficacy and application of the percutaneous left atrial appendage occlusion (PLAAO) guided only by the transesophageal echocardiography (TEE) in patients with nonvalvular atrial fibrillation (NVAF), without using the fluoroscopy and angiography.Methods: During the time period of this study from June 2020 to June 2021, 32 patients underwent PLAAO and all underwent a TEE guided approach. The anatomical features of the left atrial appendage (LAA) were evaluated and observed by TEE before and during the procedure. LAA occluder device was selected for the appropriate size. Intraoperative TEE guided and monitored the process of PLAAO in real-time, and also evaluated the stability and tightness of the occluder device, following monitored postoperative complications. Results:The PLAAO procedure was successful in all the patients. No serious complications like dislocation of the occluder and embolism were seen. Postoperative TEE demonstrated that the PLAAO occluder devices were in a good position without residual shunting.Conclusions: PLAAO only guided by TEE may become a safe and reliable surgical procedure, which can protect surgeons and patients from radiation, and can gradually become a novel surgical method of PLAAO with the practical application value.

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Role of real time‑three dimensional transesophageal echocardiography in left atrial appendage closure with LACBES� devices

Cited by 5 publications

References 13 publications

Predictive nomogram models for atrial fibrillation in COPD patients: A comprehensive analysis of risk factors and prognosis

Predictive nomogram models for atrial fibrillation in COPD patients: A comprehensive analysis of risk factors and prognosis

Three-Dimensional Transesophageal Echocardiography in Percutaneous Catheter-Based Cardiac Interventions

Clinical application of percutaneous left atrial appendage occlusion guided only by transesophageal echocardiography without fluoroscopy and angiography in the patients with nonvalvular atrial fibrillation

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