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Computed tomography measurement for left atrial appendage closure

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Percutaneous left atrial appendage closure (LAAC) has been reported many therapeutic effects with regard to its safety and efficacy, and the number of patients with non-valvular atrial fibrillation undergoing LAAC is increasing worldwide. Although it is a highly safe procedure, further improvements are expected and preoperative planning is extremely important. For this purpose, transesophageal echocardiography has been mainly performed so far, however, nowadays, it is recommended to determine a more optimal treatment strategy combined with computed tomography. Preoperative CT predicts not only the risk of the intervention based on anatomical features of the left atrial appendage (LAA) but also the device type and size, sheath type, optimal location for septal puncture and pre-procedurally clarifies the left atrium and LAA dimensions. Furthermore, postoperative CT can evaluate device-related thrombus and peri-device leak, making it possible to observe the postoperative course using less invasive methods. This study reviews the practical utility of CT in pre- and post-LAAC.

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Atrial fibrillation




Multi-slice computed tomography


Direct oral anticoagulant


Device-related thrombus


Hounsfield unit


Left atrium


Left atrial appendage


Left atrial appendage closure


Left circumflex coronary artery


Multiplanar reconstruction


Oral anticoagulant


Peri-device leak


Transesophageal echocardiography


Volume rendering


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The author thanks Naoki Hosoda for his valuable contributions for providing excellent figures.


This research received no grant from any funding agency in the public, commercial or not-for-profit sectors.

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Correspondence to Masahiko Asami.

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Dr. Asami is a clinical proctor for Boston Scientific and has received remuneration from Boston Scientific, Abbott Medical, Edwards Lifesciences, Medtronic, Canon Medical Systems, and Ziosoft.

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Asami, M., the OCEAN-SHD Investigators. Computed tomography measurement for left atrial appendage closure. Cardiovasc Interv and Ther 37, 440–449 (2022).

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