CT assessment of the left atrial appendage post-transcatheter occlusion - A systematic review and meta analysis.
J Cardiovasc Comput Tomogr
; 15(4): 348-355, 2021.
Article
em En
| MEDLINE
| ID: mdl-33384253
ABSTRACT
BACKGROUND:
Transesophageal echocardiography (TEE) is the standard imaging modality used to assess the left atrial appendage (LAA) after transcatheter device occlusion. Cardiac computed tomography angiography (CCTA) offers an alternative non-invasive modality in these patients. We aimed to conduct a comparison of the two modalities.METHODS:
We performed a comprehensive systematic review of the current literature pertaining to CCTA to establish its usefulness during follow-up for patients undergoing LAA device closure. Studies that reported the prevalence of inadequate LAA closure on both CCTA and TEE were further evaluated in a meta-analysis. 19 studies were used in the systematic review, and six studies were used in the meta-analysis.RESULTS:
The use of CCTA was associated with a higher likelihood of detecting LAA patency than the use of TEE (OR, 2.79, 95% CI 1.34-5.80, p â= â0.006, I2 â= â70.4%). There was no significant difference in the prevalence of peridevice gap ≥5 âmm (OR, 3.04, 95% CI 0.70-13.17, p â= â0.13, I2 â= â0%) between the two modalities. Studies that reported LAA assessment in early and delayed phase techniques detected a 25%-50% higher prevalence of LAA patency on the delayed imaging.CONCLUSION:
CCTA can be used as an alternative to TEE for LAA assessment post occlusion. Standardized CCTA acquisition and interpretation protocols should be developed for clinical practice.Palavras-chave
Texto completo:
1
Temas:
ECOS
/
Aspectos_gerais
Bases de dados:
MEDLINE
Assunto principal:
Fibrilação Atrial
/
Apêndice Atrial
Tipo de estudo:
Guideline
/
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
J Cardiovasc Comput Tomogr
Assunto da revista:
ANGIOLOGIA
/
CARDIOLOGIA
/
RADIOLOGIA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Estados Unidos