Contrast-enhanced Transesophageal Echocardiography Predicts Neo-intimal Coverage of Device Post-left Atrial Appendage Closure

Overview

Journal Cardiol J

Specialty Cardiology & Vascular Diseases

Date 2020 Sep 28

PMID 32986237

Citations 2

Authors

Xiaoxia Wu

Dali Fan

Wei Huang

Yuezhi Meng

Tao Wan

Ezra A Amsterdam

Yejia Shen

Yilong Chen

Dongxing Ma

Affiliations

Soon will be listed here.

Abstract

Background: Left atrial appendage (LAA) closure (LAAC) is a viable alternative to anticoagulation for stroke prevention in non-valvular atrial fibrillation. However, device-associated thrombosis (DAT) is known as a complication of LAAC as observed within the first few weeks after implantation. A noninvasive method is needed to predict the progress for endothelialization surveillance. The aim of the study was to develop a noninvasive visual contrast-enhanced transesophageal echocardiography (cTEE) method for monitoring the communication between left atrium (LA) and LAA post-LAAC by cTEE-score evaluating the contrast enhancement in LAA.

Methods: A total of 29 healthy dogs were studied by LAAC at < 24 h and 1, 2, 3 and 6-months. The LAAC procedure was assessed by TEE with color Doppler flow imaging (CDFI) and contrast imaging. The cTEE score was calculated based on the differential contrast opacification of LA and LAA cavities, the CDFI on the width of peri-device color flow, and that of histology on the level of occluder surface endothelialization in postmortem histological examination. Spearman's correlation analysis was used to correlate these scores.

Results: The correlation between cTEE and histology scores was superior to that between CDFI and histology scores. The trend of average cTEE score was tracked with that of histology, while that of CDFI was far from that of histology. The correlation coefficient of CDFI and histology scores was not significant (p > 0.05).

Conclusions: The noninvasive visual cTEE is feasible and reliable to monitor communication between the LA and LAA post-LAAC. cTEE is superior to CDFI as a tool in predicting the progress for endothelialization surveillance.

Citing Articles

The healing response of LAMax LAAC™ left atrial appendage occluder in a canine model: the potential influence of the implantation technique on the healing response.

Wu X, Ma D, Wan T, Meng Y, Chen Y, Shen Y BMC Cardiovasc Disord. 2022; 22(1):291.

PMID: 35761168 PMC: 9238264. DOI: 10.1186/s12872-022-02731-5.

Long-Term Effect of Left Atrial Appendage Occlusion in Treating Patients with Previous Ischemic Stroke on the Disease Recurrence.

Yu J, Liu Y, Sun P, Guo X, Jiang H, Fang W Comput Math Methods Med. 2021; 2021:6991002.

PMID: 34691240 PMC: 8528575. DOI: 10.1155/2021/6991002.

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