title: Implantation of left atrial appendage occlusion devices and complex appendage anatomy: the importance of transesophageal echocardiography.
abstract: Percutaneous delivery of left atrial appendage (LAA) occluding devices represents a novel approach for stroke prevention in patients with atrial fibrillation. Transesophageal echocardiography (TEE) has a pivotal role throughout these procedures, facilitating device size selection and ensuring optimal deployment of the device. We report a case of an LAA occluding device implantation in which apparent proper positioning on fluoroscopy was determined by TEE to be malpositioning with a nonocclusive, perpendicular orientation to the plane of the LAA ostium. This problem appeared to be related to a complex, multilobed LAA anatomy and was readily resolved by repositioning of the device under TEE guidance.
authors.affiliation: Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: Jesse
authors.initials: J
authors.lastname: Jorgensen
authors.forename: Spencer
authors.initials: S
authors.lastname: Palmer
authors.forename: Andreas
authors.initials: A
authors.lastname: Kalogeropoulos
authors.forename: Takeshi
authors.initials: T
authors.lastname: Arita
authors.forename: Peter
authors.initials: P
authors.lastname: Block
authors.forename: Randy
authors.initials: R
authors.lastname: Martin
authors.forename: Stamatios
authors.initials: S
authors.lastname: Lerakis
mesh_terms: D020517:Atrial Appendage / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D001281:Atrial Fibrillation / Q000150:complications / Q000628:therapy; D006328:Cardiac Catheterization; D017548:Echocardiography, Transesophageal; D006801:Humans; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D011859:Radiography; D020521:Stroke / Q000209:etiology / Q000517:prevention & control