0095: Evaluation of peri device leaks after percutaneous left atrial appendage closure using cardiac computed tomography - 12/02/16
Résumé |
Purpose |
Peridevice leaks after left atrial appendage (LAA) closure with the Amplatzer® Cardiac Plug (ACP) have been reported using trans oesophageal Echocardiography (TOE), but this evaluation is challenging, and the few available data are inconsistent. There are currently few data regarding the evaluation of cardiac CT (CT) for peridevice leaks detection. We aimed to assess the incidence and the related factors of ACP peridevice leaks using CT.
Methods |
Cardiac-CT using a multi-phase protocol and a second-generation dual-source-CT-system was performed in 45 patients with non-valvular atrial fibrillation 24h before the procedure and 3 months after LAA closure with ACP. Peridevice leak was defined as a presence of opacification of the LAA by the contast agent.
Results |
Fourty three patients were included, aged 73±9.4 years. ACP size compared to mean diameter of the landing zone measured by CT was oversized by 2.7±2.2mm. Peridevice leaks were found on CT in 18 patients (41.9%). The rate of peridevice leaks was lower among patients in whom the ACP oversizing was<3mm based on CT measurements compared to an oversizing of the device>3mm, 23.5% and 55% respectively, p=0.052. The size of the LAA landing zone did not correlate significantly with the presence of peridevice leak (20.6±3.7 vs 21.5±4.2mm, p=0.47). The shape of the LAA was not associated with peridevice leaks (p=0.39). Clinical outcome with a mean follow-up 14.7 months was similar in both groups with 1 stroke in the peride-vice leak group and 2 in the other group (5.5% and 8% respectively).
Conclusions |
Cardiac CT scan is an accurate technique for peridevice leaks detection. Important oversizing of the device is not associated with absence of residual leaks. There is a trend toward more residual leaks in the biggest LAAs. No adverse outcome were related with a residual leak.
Le texte complet de cet article est disponible en PDF.Vol 8 - N° 1
P. 41 - janvier 2016 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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