Left Atrial Appendage Filling Defects on 256-row Detector Cardiac CT Prior to Pulmonary Vein Isolation for Atrial Fibrillation—Specificity for Thrombus? An Analysis of Patient, CT and Contrast Related Factors

Autor: Michael R. Ward, Gemma A. Figtree, Logan Kanagaratnam, David Brazier, C. Choong, Warren Yan, Peter S. Hansen, David Whalley
Rok vydání: 2013
Předmět:
Zdroj: Heart, Lung and Circulation. 22:S185
ISSN: 1443-9506
DOI: 10.1016/j.hlc.2013.05.440
Popis: Background: Cardiac CT is used to define pulmonary vein anatomy prior to pulmonary vein isolation (PVI) for atrial fibrillation. Left atrial appendage (LAA) filling defects may be observed, raising concerns of thrombus. Specificity of LAA filling defects for thrombus, and potential patient,CT-acquisitionandcontrast-related influences merit evaluation. Methods:We retrospectively reviewed consecutive cardiac CT studies performed for PVI planning from August 2010 to January 2013, examining incidence of LAA filling defects. This was compared with transoesophageal echocardiogram (TOE) findings, performed in all patients. Ratio of radiodensity (HU) in the descending thoracic aorta to main pulmonary artery was calculated as a surrogate of CT scan timing. LAAneck diameterwasmeasured. Age, height, weight, body surface area (BSA), left ventricular ejection fraction (LVEF), contrast dose, total injection volume, contrast concentration were entered for multivariate analysis. Results: 122 studies were performed in 119 patients (mean age 59.4 years, 70.5% male). Fifteen LAA filling defects were identified on cardiac CT, but no TOE study demonstrated thrombus (false positive 12.3%, specificity 87.7%). Potential predictors of false positives were examined
Databáze: OpenAIRE
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