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Cardiac CT Angiography (CCTA) predicts left atrial appendage occluder device size and procedure outcome

  • Orly Goitein
  • Noam Fink
  • Ilan Hay
  • Elio Di Segni
  • Victor Guetta
  • David Goitein
  • Yafim Brodov
  • Eli Konen
  • Michael Glikson
Original Paper

Abstract

Aim

To investigate the role of cardiac CT angiography (CCTA) in predicting optimal left atrial appendage (LAA) occluder size and procedure outcome.

Methods and results

Thirty-six patients underwent pre-procedural CCTA. CCTA and TEE LAA orifice diameters and perimeters were compared with the implanted device size. CCTA 3D configuration was correlated with procedure outcome. Watchman™ device (N = 18): diameters were 21 ± 4, 26 ± 5 and 25 ± 3 mm for TEE, CCTA and inserted device, respectively. Average perimeters were 61 ± 10, 74 ± 8 and 78 ± 11 mm for TEE, CCTA and inserted device, respectively. Better agreement with the device size was found for CCTA compared to TEE (Bland–Altman). ACP™ device (N = 15): diameters were 20 ± 5, 25 ± 4 and 23 ± 4 for TEE, CCTA and inserted device, respectively. Average perimeters were 58 ± 11, 72 ± 15 and 72 ± 13 mm for TEE, CCTA and inserted device, respectively. Excellent correlation and agreement with the device size was found for CCTA compared to TEE. CCTA perimeter >100 mm and “cactus” 3D configuration had a specificity of 96 and 81% respectively for procedure failure.

Conclusions

CCTA LAA ostial perimeter predicted better the optimal occluder size as compared with the currently used LAA TEE diameter. Moreover, CCTA 3D data may help in predicting potential complications.

Keywords

CCTA LAA occluder device LAA 3D 

Notes

Acknowledgements

The authors would like to thank Ilia Novikov for his contribution in the statistical analysis.

Compliance with ethical standards

Conflict of interest

All authors have no conflict of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media Dordrecht 2017

Authors and Affiliations

  1. 1.Department of Diagnostic ImagingChaim Sheba Medical CenterRamat GanIsrael
  2. 2.Heart CenterChaim Sheba Medical CenterRamat GanIsrael
  3. 3.Department of Surgery CChaim Sheba Medical CenterRamat GanIsrael
  4. 4.The Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael

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