Anatomical classification of left atrial appendages in specimens applicable to CT imaging techniques for implantation of amplatzer cardiac plug

Autor:	José R, López-Mínguez, Reyes, González-Fernández, Concepción, Fernández-Vegas, Victoria, Millán-Nuñez, María E, Fuentes-Cañamero, Juan M, Nogales-Asensio, Javier, Doncel-Vecino, Javier, Elduayen-Gragera, Siew Y, Ho, Damián, Sánchez-Quintana
Rok vydání:	2014
Předmět:	Male Prosthesis Implantation Imaging Three-Dimensional Septal Occluder Device Cadaver Humans Atrial Appendage Longitudinal Studies Prospective Studies Tomography X-Ray Computed Aged
Zdroj:	Journal of cardiovascular electrophysiology. 25(9)
ISSN:	1540-8167
Popis:	Certain anatomical characteristics of the left atrial appendage (LAA) are associated with complexity in the implantation of occluder devices.The aim was to define characteristics measurable by three-dimensional imaging that would predict complexities both in the implantation procedure and the selection of the appropriate device size.An anatomical study was performed of 50 postmortem hearts, of which 15 had a history of atrial fibrillation, and of 30 consecutive patients undergoing LAA occlusion with the Amplatzer cardiac plug (ACP). The specimens were classified according to variables that can be visualized using computerized tomography (CT). The CT scans of 30 consecutive patients were classified according to the level of the LAA ostium, the left lateral ridge (LLR), the LAA limbus and distance from LAA to the mitral annulus before undergoing LAA occlusion, and the results were correlated.Three types of LAA orifice were defined: type I, with a usually higher, anterior LAA ostium, a short, flattened and wide LLR and almost nonexistent limbus; type II, presenting a long, pointed and narrow LLR, and a longer, more defined limbus; type III, with a lower LAA ostium, close to the left atrium floor and the mitral annulus, a marked separation from the left pulmonary vein orifices and a limbus of intermediate length.LAA with lower ostia are more difficult to occlude. Types II and III have very prominent LLRs with longer limbi, which may increase the difficulty of inserting the guide and making measurements for selection of the right ACP size.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=pmid________::68cd859e0e569062c5cd4c6d7fe5f89e https://pubmed.ncbi.nlm.nih.gov/24716814 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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