CT imaging for left atrial appendage closure: A review and pictorial essay

• Published in: Journal of cardiovascular computed tomography Vol. 9; no. 2; pp. 89 - 102
• Main Authors: Ismail, Tevfik Fehmi, BSc(Hons), MBBS(Lond), PhD, MRCP(UK), Panikker, Sandeep, BSc(Hons), MBBS(Lond), MRCP(UK), Markides, Vias, MD, FRCP, Foran, John P., MD, FRCP, Padley, Simon, FRCR, Rubens, Michael B., FRCR, Wong, Tom, MD, FRCP, Nicol, Edward, MD, MBA, DAvMed, MRCP, FACC, FSCCT
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2015
• Subjects: Amplatzer Cardiac Plug; Atrial Appendage - diagnostic imaging; Atrial Appendage - pathology; Atrial Fibrillation; Atrial Fibrillation - diagnostic imaging; Atrial Fibrillation - therapy; Cardiac Catheterization - methods; Cardiovascular; Cardiovascular CT; Female; Humans; Lariat; Left Atrial Appendage; Male; Photography; Prognosis; Radiographic Image Enhancement; Risk Assessment; Septal Occluder Device; Stroke; Stroke - prevention & control; Tomography, X-Ray Computed - methods; Treatment Outcome; Watchman device; Stroke; Lariat; Amplatzer Cardiac Plug; Watchman device; Left Atrial Appendage; Atrial Fibrillation; Cardiovascular CT
• ISSN: 1934-5925; 1876-861X
• DOI: 10.1016/j.jcct.2015.01.011

Abstract Cardioembolic stroke is an important complication of atrial fibrillation. The thrombus responsible for this arises from the left atrial appendage (LAA) in >90% of cases, providing the rationale for device-based LAA closure as a means of thromboprophylaxis. Although oral anticoagulant therapy remains the mainstay for reducing the risk of stroke in patients with atrial fibrillation, an increasing number of patients, particularly those ineligible for conventional pharmacotherapy, are being offered percutaneous left atrial appendage closure. Cardiovascular CT can provide important information to assess the suitability of patients for LAA interventions and guide device selection and approach. The high spatial resolution and multiplanar capability of contemporary contrast-enhanced gated multidetector cardiovascular CT render it an ideal modality for noninvasively evaluating patients before intervention and assessing patients after intervention both for complications and procedural outcome.