Abstract
Transesophageal echocardiography (TEE) is the most common imaging method for evaluating left atrial morphology. Recent advances in 64-slice multidetector computed tomography (64-MDCT) allow accurate measurement of left atrial appendage (LAA) volume. The aim of this study was to evaluate the accuracy of LAA sizing by TEE in comparison with 64-MDCT in patients with atrial fibrillation. Electrocardiogram-gated 64-MDCT and TEE were performed within 2 days in 18 consecutive patients (63 ± 9 years old, 12 males, 5 paroxysmal atrial fibrillation) with nonvalvular atrial fibrillation. LAA area and LAA volume were measured at end-systole by TEE and 64-MDCT, respectively. The largest LAA area was measured on TEE image. Five patients were in sinus rhythm during examinations. In all patients, LAA was clearly visualized; the largest area of LAA was 9.3 ± 3.9 mm2 and the LAA volume was 21.6 ± 7.5 ml. A significant correlation between LAA area and LAA volume was observed (p = 0.0003, r = 0.75). TEE allows a detailed evaluation of the LAA structure by two-dimensional imaging. LAA size could be evaluated by TEE despite its morphological complexity, i.e., sac-like or multilobed structure.
References
Klein AL, Grimm RA, Murray RD, et al. Use of transesophageal echocardiography to guide cardioversion in patients with atrial fibrillation. N Engl J Med. 2001;344:1411–20.
Omran H, Rang B, Schmidt H, et al. Incidence of left atrial thrombi in patients in sinus rhythm and with a recent neurologic deficit. Am Heart J. 2000;140:658–62.
Agmon Y, Khandheria BK, Gentile F, et al. Echocardiographic assessment of the left atrial appendage. J Am Coll Cardiol. 1999;34:1867–77.
Nair CK, Holmberg MJ, Aronow WS, et al. Thromboembolism in patients with atrial fibrillation with and without left atrial thrombus documented by transesophageal echocardiography. Am J Ther. 2009;16:385–92.
Singh NK, Nallamothu N, Zuck VP, et al. Left atrial appendage filling defects on 64-slice multidetector computed tomography in patients undergoing pulmonary vein isolation: predictors and comparison to transesophageal echocardiography. J Comput Assist Tomogr. 2009;33:946–51.
Qamruddin S, Shinbane J, Shriki J, et al. Left atrial appendage: structure, function, imaging modalities and therapeutic options. Expert Rev Cadiovasc Ther. 2010;8:65–75.
Seward JB, Khandheria BK, Oh JK, et al. Critical appraisal of transesophageal echocardiography: limitations, pitfalls, and complications. J Am Soc Echocardiogr. 1992;5:288–305.
Veinot JP, Harrioty PJ, Gentile F, et al. Anatomy of the left atrial appendage. Circulation. 1997;96:3112–5.
Donal E, Yamada H, Leclercq C, et al. The left atrial appendage, a small, blind-ended structure. Chest. 2005;128:1853–62.
Latcu DG, Rnaldi JP, Saoudi V. Real-time three-dimensional transesophageal echocardiography for diagnosis of left atrial appendage thrombus. Eur J Echocardiogr. 2009;10:711–2.
Hutchinson MD, Jacobson JT, Michele JJ, et al. A comparison of intracardiac and transesophageal echocardiography to detect left atrial appendage thrombus in a swine model. J Interv Card Electrophysiol. 2010;27:3–7.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Yoshimoto, K., Mizushige, K., Lu, X. et al. Measurement of left atrial appendage size by transesophageal echocardiography. J Med Ultrasonics 39, 33–35 (2012). https://doi.org/10.1007/s10396-011-0331-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10396-011-0331-x