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Left Atrial Appendage white paper

Left Atrial Appendage white paper

Left Atrial Appendage white paper

Product catalog summary
Assessment of the Left Atrial Appendage (LAA): The document discusses the use of MSCT imaging to evaluate the anatomy, size, and presence of thrombus in the LAA. This is crucial for patients with atrial fibrillation, as thrombus formation in the LAA can lead to strokes if dislodged into the bloodstream. Pre-operative planning using MSCT aids in selecting appropriate percutaneous LAA closure devices to prevent such events.
The LAA and Thrombus Formation: The LAA, attached to the left atrium, can vary in shape and size. In normal heart rhythms, it contracts with the atrium, ejecting blood. However, in atrial fibrillation, blood may stagnate and form clots, with 90% of stroke-causing clots originating from the LAA.
Percutaneous Closure of the LAA: Various devices, such as the Boston Scientific Watchman and St. Jude Medical Amplatzer, are available for LAA closure. These are delivered percutaneously, and planning in the catheterization lab is essential.
Dedicated LAA Workflow:
  • 3D Anatomy: MSCT visualizes different LAA shapes, aiding in device selection and implantation depth.
  • Presence of Thrombus: MPR CT images can easily distinguish thrombus from blood.
  • Ostium Size and Position: Landmarks in the circumflex coronary artery and Coumadin ridge help trace the LAA ostium, crucial for device selection.
  • Optimal C-Arm Projection: CTA images suggest C-arm angles for procedures, reducing the need for extra contrast or X-ray exposure.
Conclusion: MSCT is vital for pre-operative planning of LAA closure procedures, addressing factors like LAA shape, ostium size and position, and thrombus presence.
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Catalog excerpts

Left Atrial Appendage white paper-1

Pre-operative planning PIE MEDICAL IMAGING solutions in cardiovascular analysis

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Left Atrial Appendage white paper-2

Assessment of the Left Atrial Appendage (LAA) based on MSCT imaging yields useful information regarding anatomy, size and presence of thrombus. Patients with presence of thrombus in the LAA who have atrial fibrillation are at risk of stroke when the thrombus would dislodge from the LAA and enter the main bloodstream. To prevent thrombus from entering the blood stream several percutaneous LAA closure devices are available. Pre-operative planning based on MSCT imaging can assist in device selection and preparation for the procedure in the catheterization laboratory [1]. The LAA and thrombus formation...

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Left Atrial Appendage white paper-3

The solution – Dedicated LAA workflow OSTIUM SIZE, POSITION By identifying two landmarks, one in the circumflex coronary artery and one in the Coumadin ridge, the ostium of the LAA is traced. The size of the ostium is automatically presented. The size of the ostium is important for device selection. Using MSCT the different shapes of the LAA can easily be visualized. In below examples the different shapes are shown [3]. The shape of the appendage can be important for device selection and implantation depth. PRESENCE OF THROMBUS On the MPR CT images presence of thrombus can be seen easily as it...

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Left Atrial Appendage white paper-4

OPTIMAL C-ARM PROJECTION Fluoroscopic/angiographic-like images can be created based on CTA images providing suggestive C-arm angles for specific views. It can help determine appropriate c-arm angles to perform procedures and understand viewing angles without extra contrast or X-ray exposure. Conclusion MSCT facilitates pre-operative planning of percutaneous LAA closure procedures and can address important factors such as shape of the LAA, ostium size and position and thrombus presence. References [1] Wang Y, Di Biase L, Natale A. Left atrial appendage studies by computed tomography to help planning...

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