Author + information
- Received April 26, 2019
- Revision received August 5, 2019
- Accepted August 14, 2019
- Published online February 3, 2020.
- Kasper Korsholm, MDa,
- Sergio Berti, MDb,
- Xavier Iriart, MDc,
- Jacqueline Saw, MDd,
- Dee Dee Wang, MDe,
- Hubert Cochet, MD, PhDc,
- Danny Chow, MDf,
- Alberto Clemente, MDg,
- Ole De Backer, MD, PhDh,
- Jesper Møller Jensen, MD, PhDa and
- Jens Erik Nielsen-Kudsk, MD, DMSca,∗ ()
- aDepartment of Cardiology, Aarhus University Hospital, Aarhus, Denmark
- bDepartment of Cardiology, Fondazione CNR Regione Toscana, Massa, Italy
- cBordeaux University Hospital (CHU), IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Bordeaux, France
- dDivision of Cardiology, Vancouver General Hospital, Vancouver, British Columbia, Canada
- eCenter for Structural Heart Disease, Division of Cardiology, Henry Ford Health System, Detroit, Michigan
- fDepartment of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China
- gDepartment of Radiology, Fondazione CNR Regione Toscana, Massa, Italy
- hDepartment of Cardiology, Heart Center, Rigshospitalet, Copenhagen, Denmark
- ↵∗Address for correspondence:
Dr. Jens Erik Nielsen-Kudsk, Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus N, Denmark.
• Cardiac CT is increasingly used to plan transcatheter LAAO.
• High-quality multiplanar and 3D imaging allow accurate device sizing and efficient LAAO.
• A standardized protocol for cardiac CT is paramount for a high-quality result.
• Pre-procedural cardiac CT may improve the accuracy, efficacy, and safety of LAAO.
Transcatheter left atrial appendage occlusion is an increasingly used alternative to oral anticoagulation in selected patients with atrial fibrillation. Pre-procedural imaging is a prerequisite to a successful intervention, with transesophageal echocardiography as the current gold standard. However, cardiac computed tomography offers improved imaging with high-quality multiplanar and 3-dimensional reconstructed images. Nevertheless, the lack of a standardized imaging protocol has slowed the adoption of cardiac computed tomography into clinical practice. On the basis of current research and expert consensus, this paper provides a protocol for the preparation, acquisition, and interpretation of cardiac computed tomographic imaging in pre-procedural planning of left atrial appendage occlusion.
- CT scanner requirements
- left atrial appendage thrombus detection and measurements
- contrast injection
- patient preparation
Dr. Korsholm has received a speaking honorarium from Abbott. Dr. Berti is a proctor for Abbott and Edwards Lifesciences. Dr. Iriart is a proctor for Boston Scientific and Abbott. Dr. Saw has received unrestricted research grant support from AstraZeneca, Abbott, Boston Scientific, and Servier; has received speaking honoraria from AstraZeneca, Abbott, Boston Scientific, and Sunovion; and is a consultant and/or proctor for Boston Scientific, AstraZeneca, and Abbott. Dr. Wang has received research grant support from Boston Scientific; and is a consultant for Edwards Lifesciences, Boston Scientific, and Materialise. Dr. De Backer has been a consultant for Boston Scientific and Abbott. Dr. Møller Jensen has received a speaking honorarium from Bracco Imaging. Dr. Nielsen-Kudsk is a consultant for Boston Scientific; and is a consultant and proctor for Abbott. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received April 26, 2019.
- Revision received August 5, 2019.
- Accepted August 14, 2019.
- 2020 American College of Cardiology Foundation
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