title: Left atrial appendage closure: beyond the artifact.
abstract: : Transesophageal echocardiography (TEE) represents the gold standard technique to detect left atrial appendage (LAA) thrombosis. Several conditions may be erroneously interpreted as LAA thrombus at TEE, including artifacts mimicking thrombi. We report a case of a 78-year-old man with atrial fibrillation and contraindication to anticoagulation who was referred to our institution for percutaneous left appendage closure with a transcatheter trans-septal approach. Intraoperative transesophageal echocardiography revealed a thrombus-mimicking image, related to reverberations of left upper pulmonary vein ridge, located at twice the distance of the ridge from the transducer.
authors.affiliation: aDepartment of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padua, Italy *Gianpiero D'Amico and Marco Mojoli contributed equally to the writing of this article.
authors.forename: Gianpiero
authors.initials: G
authors.lastname: D'Amico
authors.forename: Marco
authors.initials: M
authors.lastname: Mojoli
authors.forename: Paolo
authors.initials: P
authors.lastname: Buja
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tarantini
mesh_terms: D000368:Aged; D016477:Artifacts; D020517:Atrial Appendage / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006328:Cardiac Catheterization / Q000295:instrumentation*; D002932:Cineangiography; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D061330:Multidetector Computed Tomography; D011237:Predictive Value of Tests; D011667:Pulmonary Veins / Q000000981:diagnostic imaging; D016896:Treatment Outcome