Relation of left atrial appendage closure devices to topographic neighboring structures using standardized imaging by cardiac computed tomography angiography

• Verfasst von: Lindner, Simon [VerfasserIn]
• Verfasst von: Behnes, Michael [VerfasserIn]
• Verfasst von: Wenke, Annika [VerfasserIn]
• Verfasst von: Sartorius, Benjamin [VerfasserIn]
• Verfasst von: Dieker, Wulf [VerfasserIn]
• Verfasst von: Ansari, Uzair [VerfasserIn]
• Verfasst von: Vogler, Nils [VerfasserIn]
• Verfasst von: Haubenreisser, Holger [VerfasserIn]
• Verfasst von: Schönberg, Stefan [VerfasserIn]
• Verfasst von: Borggrefe, Martin [VerfasserIn]
• Verfasst von: Akın, Ibrahim [VerfasserIn]
• Verfasst von: Bertsch, Thomas [VerfasserIn]
• Titel: Relation of left atrial appendage closure devices to topographic neighboring structures using standardized imaging by cardiac computed tomography angiography
• Verf.angabe: Simon Lindner, Michael Behnes, Annika Wenke, Benjamin Sartorius, Wulf Dieker, Uzair Ansari, Muharrem Akin, Thomas Bertsch, Kambis Mashayekhi, Nils Vogler, Holger Haubenreisser, Stefan O. Schoenberg, Martin Borggrefe, Ibrahim Akin
• Jahr: 2019
• Umfang: 6 S.
• Fussnoten: First published: 11 December 2018 ; Gesehen am 04.12.2019
• Titel Quelle: Enthalten in: Clinical cardiology
• Ort Quelle: Weinheim [u.a.] : Wiley, 1978
• Jahr Quelle: 2019
• Band/Heft Quelle: 42(2019), 2, Seite 264-269
• ISSN Quelle: 1932-8737
• DOI: doi:10.1002/clc.23136
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: cardiac computed tomography angiography
• Sach-SW: left atrial appendage closure
• Sach-SW: LOVE
• Sach-SW: neighboring structures
• Sach-SW: standardized imaging protocol
• K10plus-PPN: 1677559780

Abstract

Background Although left atrial appendage (LAA) anatomy and topographic relations are well understood, little is known about the impairment of neighboring structures (NBS) by an implanted left atrial appendage closure (LAAC) device. This prospective longitudinal observational study for the first time describes distances of implanted LAA closure (LAAC) devices to NBS using a standardized imaging protocol of cardiac computed tomography angiography (cCTA). Hypothesis cCTA imaging is an eligible tool for post-implantation evaluation of LAAC devices and their relation to neighboring structures. Methods cCTA data sets of consecutive patients 6 months after successful LAAC were acquired on a third generation dual-source CT system and reconstructed with a slice thickness of 0.5 mm. The standardized multi-planar reconstruction LAA occluder view for post-implantation evaluation (LOVE) algorithm was used to measure the distances to NBS in relation to LAA morphology and implanted LAAC devices. Results A total of 48 patients (median age 80 years, 25% female) were included. Left upper pulmonary vein and circumflex artery were generally closest to occlusion devices (median 2.9 and 2.8 mm, respectively). AMPLATZER AMULET devices were closer to the mitral valve annulus than WATCHMAN devices (6.6 mm (inter quartile range [IQR] 4.9-8.6) vs 10.9 mm (IQR 7.4-14.0), P = 0.001). Distances to the left upper pulmonary vein were affected by LAA morphology, with cauliflower type having the closest proximity (1.7 mm [IQR 1.0-3.4], P = 0.048). Conclusion A standardized cCTA imaging protocol is an eligible tool to accurately measure distances to NBS. Left upper pulmonary vein and circumflex artery are closest to LAAC devices and could thus be most prone to impairment.