A Comparative Study of Three Imaging Modalities for Size Selection of a Watchman Left Atrial Appendage Closure Device
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Purpose: To compare the results of computed tomography angiography (CTA), transesophageal echocardiography (TEE), anddigital subtraction angiography (DSA) measurements and analyze their accuracy, correlation, and consistency in patients whohave successfully undergone left atrial appendage closure (LAAC). Materials and Methods: A total of 157 non-valvular atrial fibrillation (AF) patients who underwent LAAC with Watchman deviceswere included in the study. The maximum diameter and depth of LAA were recorded using CTA, TEE, and DSA. Correlations andagreements were compared. Results: The LAAC procedure was performed successfully in all patients using the Watchman device. There was no significantdifference between DSA and TEE measurements of the diameter of the LAA ostium. LAA ostium diameter obtained by CTA,however, was greater than that from DSA and TEE. Correlations were good between LAA ostium diameter measured by TEE,CTA, and DSA and Watchman device size. DSA measurements and actual device size showed the widest limits of agreement, followedby TEE; CTA measurements showed the narrowest limits of agreement. For LAA depth measurements, mean CTA measurementswere higher than those of TEE and DSA. There was no significant difference in depth measurements among the threeimaging modalities. Conclusion: CTA, TEE, and DSA measurements exhibited good correlations with Watchman device size. The ostium diameterand depth of the LAA measured by CTA were greater than those measured by TEE and DSA. The relevance and concordance ofCTA measurements were the strongest.
Abstract
Purpose: To compare the results of computed tomography angiography (CTA), transesophageal echocardiography (TEE), anddigital subtraction angiography (DSA) measurements and analyze their accuracy, correlation, and consistency in patients whohave successfully undergone left atrial appendage closure (LAAC). Materials and Methods: A total of 157 non-valvular atrial fibrillation (AF) patients who underwent LAAC with Watchman deviceswere included in the study. The maximum diameter and depth of LAA were recorded using CTA, TEE, and DSA. Correlations andagreements were compared. Results: The LAAC procedure was performed successfully in all patients using the Watchman device. There was no significantdifference between DSA and TEE measurements of the diameter of the LAA ostium. LAA ostium diameter obtained by CTA,however, was greater than that from DSA and TEE. Correlations were good between LAA ostium diameter measured by TEE,CTA, and DSA and Watchman device size. DSA measurements and actual device size showed the widest limits of agreement, followedby TEE; CTA measurements showed the narrowest limits of agreement. For LAA depth measurements, mean CTA measurementswere higher than those of TEE and DSA. There was no significant difference in depth measurements among the threeimaging modalities. Conclusion: CTA, TEE, and DSA measurements exhibited good correlations with Watchman device size. The ostium diameterand depth of the LAA measured by CTA were greater than those measured by TEE and DSA. The relevance and concordance ofCTA measurements were the strongest.
참고문헌 (12)
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