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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...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Society of Echocardiography
2015
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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 |
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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 |
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