Percutaneous interventions for left atrial appendage exclusion: options, assessment, and imaging using 2D and 3D echocardiography

Percutaneous left atrial appendage (LAA) exclusion is an evolving treatment to prevent embolic events in patients with nonvalvular atrial fibrillation. In the past few years multiple percutaneous devices have been developed to exclude the LAA from the body of the left atrium and thus from the system...

Full description

Saved in:
Bibliographic Details
Published in:JACC. Cardiovascular imaging 2015-04, Vol.8 (4), p.472-488
Main Authors: Wunderlich, Nina C, Beigel, Roy, Swaans, Martin J, Ho, Siew Yen, Siegel, Robert J
Format: Article
Language:English
Subjects:
Atrial Appendage - diagnostic imaging
Atrial Appendage - physiopathology
Atrial Fibrillation - physiopathology
Atrial Fibrillation - therapy
Echocardiography - methods
Echocardiography, Three-Dimensional
Heart Atria - diagnostic imaging
Heart Atria - physiopathology
Humans
Percutaneous Coronary Intervention
Stroke - prevention & control
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Percutaneous left atrial appendage (LAA) exclusion is an evolving treatment to prevent embolic events in patients with nonvalvular atrial fibrillation. In the past few years multiple percutaneous devices have been developed to exclude the LAA from the body of the left atrium and thus from the systemic circulation. Two- and 3-dimensional transesophageal echocardiography (TEE) is used to assess the LAA anatomy and its suitability for percutaneous closure to select the type and size of the closure device and to guide the device implantation procedure in conjunction with fluoroscopy. In addition, 2- and 3-dimensional TEE is also used to assess the effectiveness of device implantation acutely and on subsequent follow-up examination. Knowledge of the implantation options that are currently available along with their specific characteristics is essential for choosing the appropriate device for a given patient with a specific LAA anatomy. We present the currently available LAA exclusion devices and the echocardiographic imaging approaches for evaluation of the LAA before, during, and after LAA occlusion.
ISSN:1876-7591
DOI:10.1016/j.jcmg.2015.02.002