Author + information
- Received December 2, 2014
- Revision received January 22, 2015
- Accepted February 5, 2015
- Published online April 1, 2015.
- Nina C. Wunderlich, MD∗,
- Roy Beigel, MD†,‡,
- Martin J. Swaans, MD, PhD§,
- Siew Yen Ho, MD‖ and
- Robert J. Siegel, MD†∗ ()
- ∗Cardiovascular Center Darmstadt, Darmstadt, Germany
- †The Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
- ‡The Heart Institute, Sheba Medical Center, and the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- §Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands
- ‖Cardiac Morphology Unit, Royal Brompton Hospital, London, United Kingdom
- ↵∗Reprint requests and correspondence:
Dr. Robert J. Siegel, Cedars Sinai Medical Center, 127 South San Vicente Boulevard, Suite A3600, Los Angeles, California 90048.
Percutaneous left atrial appendage (LAA) exclusion is an evolving treatment to prevent embolic events in patients with nonvalvular atrial fibrillation. In the past few years multiple percutaneous devices have been developed to exclude the LAA from the body of the left atrium and thus from the systemic circulation. Two- and 3-dimensional transesophageal echocardiography (TEE) is used to assess the LAA anatomy and its suitability for percutaneous closure to select the type and size of the closure device and to guide the device implantation procedure in conjunction with fluoroscopy. In addition, 2- and 3-dimensional TEE is also used to assess the effectiveness of device implantation acutely and on subsequent follow-up examination. Knowledge of the implantation options that are currently available along with their specific characteristics is essential for choosing the appropriate device for a given patient with a specific LAA anatomy. We present the currently available LAA exclusion devices and the echocardiographic imaging approaches for evaluation of the LAA before, during, and after LAA occlusion.
Dr. Wunderlich has received speaker honoraria from St. Jude Medical and Philips Ultrasound. Dr. Swaans is a proctor for Boston Scientific. Dr. Siegel has received educational funding from Philips Ultrasound. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Drs. Wunderlich and Beigel contributed equally to this work.
- Received December 2, 2014.
- Revision received January 22, 2015.
- Accepted February 5, 2015.
- 2015 American College of Cardiology Foundation
- Current Devices for Percutaneous LAA Occlusion or Exclusion
- Imaging Modalities and General Imaging Aspects in Procedure Planning
- Specific Imaging Aspects in Pre-Procedure Planning
- Periprocedural Echocardiographic Assessment
- Post-Procedural Echocardiographic Follow-Up