Cargando…

Predicting Peri-Device Leakage of Left Atrial Appendage Device Closure Using Novel Three-Dimensional Geometric CT Analysis

BACKGROUND: After left atrial appendage (LAA) device closure, peri-device leakage into the LAA persists due to incomplete occlusion. We hypothesized that pre-procedural three-dimensional (3D) geometric analysis of the interatrial septum (IAS) and LAA orifice can predict this leakage. We investigated...

Descripción completa

Detalles Bibliográficos
Autores principales: Chung, Hyemoon, Jeon, Byunghwan, Chang, Hyuk-Jae, Han, Dongjin, Shim, Hackjoon, Cho, In Jeong, Shim, Chi Young, Hong, Geu-Ru, Kim, Jung-Sun, Jang, Yangsoo, Chung, Namsik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Echocardiography 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4707306/
https://www.ncbi.nlm.nih.gov/pubmed/26755929
http://dx.doi.org/10.4250/jcu.2015.23.4.211
_version_ 1782409287240253440
author Chung, Hyemoon
Jeon, Byunghwan
Chang, Hyuk-Jae
Han, Dongjin
Shim, Hackjoon
Cho, In Jeong
Shim, Chi Young
Hong, Geu-Ru
Kim, Jung-Sun
Jang, Yangsoo
Chung, Namsik
author_facet Chung, Hyemoon
Jeon, Byunghwan
Chang, Hyuk-Jae
Han, Dongjin
Shim, Hackjoon
Cho, In Jeong
Shim, Chi Young
Hong, Geu-Ru
Kim, Jung-Sun
Jang, Yangsoo
Chung, Namsik
author_sort Chung, Hyemoon
collection PubMed
description BACKGROUND: After left atrial appendage (LAA) device closure, peri-device leakage into the LAA persists due to incomplete occlusion. We hypothesized that pre-procedural three-dimensional (3D) geometric analysis of the interatrial septum (IAS) and LAA orifice can predict this leakage. We investigated the predictive parameters of LAA device closure obtained from baseline cardiac computerized tomography (CT) using a novel 3D analysis system. METHODS: We conducted a retrospective study of 22 patients who underwent LAA device closure. We defined peri-device leakage as the presence of a Doppler signal inside the LAA after device deployment (group 2, n = 5) compared with patients without peri-device leakage (group 1, n = 17). Conventional parameters were measured by cardiac CT. Angles θ and φ were defined between the IAS plane and the line, linking the LAA orifice center and foramen ovale. RESULTS: Group 2 exhibited significantly better left atrial (LA) function than group 1 (p = 0.031). Pre-procedural θ was also larger in this group (41.9° vs. 52.3°, p = 0.019). The LAA cauliflower-type morphology was more common in group 2. Overall, the patients' LA reserve significantly decreased after the procedure (21.7 mm(3) vs. 17.8 mm(3), p = 0.035). However, we observed no significant interval changes in pre- and post-procedural values of θ and φ in either group (all p > 0.05). CONCLUSION: Angles between the IAS and LAA orifice might be a novel anatomical parameter for predicting peri-device leakage after LAA device closure. In addition, 3D CT analysis of the LA and LAA orifice could be used to identify clinically favorable candidates for LAA device closure.
format Online
Article
Text
id pubmed-4707306
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher Korean Society of Echocardiography
record_format MEDLINE/PubMed
spelling pubmed-47073062016-01-11 Predicting Peri-Device Leakage of Left Atrial Appendage Device Closure Using Novel Three-Dimensional Geometric CT Analysis Chung, Hyemoon Jeon, Byunghwan Chang, Hyuk-Jae Han, Dongjin Shim, Hackjoon Cho, In Jeong Shim, Chi Young Hong, Geu-Ru Kim, Jung-Sun Jang, Yangsoo Chung, Namsik J Cardiovasc Ultrasound Original Article BACKGROUND: After left atrial appendage (LAA) device closure, peri-device leakage into the LAA persists due to incomplete occlusion. We hypothesized that pre-procedural three-dimensional (3D) geometric analysis of the interatrial septum (IAS) and LAA orifice can predict this leakage. We investigated the predictive parameters of LAA device closure obtained from baseline cardiac computerized tomography (CT) using a novel 3D analysis system. METHODS: We conducted a retrospective study of 22 patients who underwent LAA device closure. We defined peri-device leakage as the presence of a Doppler signal inside the LAA after device deployment (group 2, n = 5) compared with patients without peri-device leakage (group 1, n = 17). Conventional parameters were measured by cardiac CT. Angles θ and φ were defined between the IAS plane and the line, linking the LAA orifice center and foramen ovale. RESULTS: Group 2 exhibited significantly better left atrial (LA) function than group 1 (p = 0.031). Pre-procedural θ was also larger in this group (41.9° vs. 52.3°, p = 0.019). The LAA cauliflower-type morphology was more common in group 2. Overall, the patients' LA reserve significantly decreased after the procedure (21.7 mm(3) vs. 17.8 mm(3), p = 0.035). However, we observed no significant interval changes in pre- and post-procedural values of θ and φ in either group (all p > 0.05). CONCLUSION: Angles between the IAS and LAA orifice might be a novel anatomical parameter for predicting peri-device leakage after LAA device closure. In addition, 3D CT analysis of the LA and LAA orifice could be used to identify clinically favorable candidates for LAA device closure. Korean Society of Echocardiography 2015-12 2015-12-30 /pmc/articles/PMC4707306/ /pubmed/26755929 http://dx.doi.org/10.4250/jcu.2015.23.4.211 Text en Copyright © 2015 Korean Society of Echocardiography http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Chung, Hyemoon
Jeon, Byunghwan
Chang, Hyuk-Jae
Han, Dongjin
Shim, Hackjoon
Cho, In Jeong
Shim, Chi Young
Hong, Geu-Ru
Kim, Jung-Sun
Jang, Yangsoo
Chung, Namsik
Predicting Peri-Device Leakage of Left Atrial Appendage Device Closure Using Novel Three-Dimensional Geometric CT Analysis
title Predicting Peri-Device Leakage of Left Atrial Appendage Device Closure Using Novel Three-Dimensional Geometric CT Analysis
title_full Predicting Peri-Device Leakage of Left Atrial Appendage Device Closure Using Novel Three-Dimensional Geometric CT Analysis
title_fullStr Predicting Peri-Device Leakage of Left Atrial Appendage Device Closure Using Novel Three-Dimensional Geometric CT Analysis
title_full_unstemmed Predicting Peri-Device Leakage of Left Atrial Appendage Device Closure Using Novel Three-Dimensional Geometric CT Analysis
title_short Predicting Peri-Device Leakage of Left Atrial Appendage Device Closure Using Novel Three-Dimensional Geometric CT Analysis
title_sort predicting peri-device leakage of left atrial appendage device closure using novel three-dimensional geometric ct analysis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4707306/
https://www.ncbi.nlm.nih.gov/pubmed/26755929
http://dx.doi.org/10.4250/jcu.2015.23.4.211
work_keys_str_mv AT chunghyemoon predictingperideviceleakageofleftatrialappendagedeviceclosureusingnovelthreedimensionalgeometricctanalysis
AT jeonbyunghwan predictingperideviceleakageofleftatrialappendagedeviceclosureusingnovelthreedimensionalgeometricctanalysis
AT changhyukjae predictingperideviceleakageofleftatrialappendagedeviceclosureusingnovelthreedimensionalgeometricctanalysis
AT handongjin predictingperideviceleakageofleftatrialappendagedeviceclosureusingnovelthreedimensionalgeometricctanalysis
AT shimhackjoon predictingperideviceleakageofleftatrialappendagedeviceclosureusingnovelthreedimensionalgeometricctanalysis
AT choinjeong predictingperideviceleakageofleftatrialappendagedeviceclosureusingnovelthreedimensionalgeometricctanalysis
AT shimchiyoung predictingperideviceleakageofleftatrialappendagedeviceclosureusingnovelthreedimensionalgeometricctanalysis
AT honggeuru predictingperideviceleakageofleftatrialappendagedeviceclosureusingnovelthreedimensionalgeometricctanalysis
AT kimjungsun predictingperideviceleakageofleftatrialappendagedeviceclosureusingnovelthreedimensionalgeometricctanalysis
AT jangyangsoo predictingperideviceleakageofleftatrialappendagedeviceclosureusingnovelthreedimensionalgeometricctanalysis
AT chungnamsik predictingperideviceleakageofleftatrialappendagedeviceclosureusingnovelthreedimensionalgeometricctanalysis