title: CT imaging for left atrial appendage closure: a review and pictorial essay.
abstract: Cardioembolic stroke is an important complication of atrial fibrillation. The thrombus responsible for this arises from the left atrial appendage (LAA) in >90% of cases, providing the rationale for device-based LAA closure as a means of thromboprophylaxis. Although oral anticoagulant therapy remains the mainstay for reducing the risk of stroke in patients with atrial fibrillation, an increasing number of patients, particularly those ineligible for conventional pharmacotherapy, are being offered percutaneous left atrial appendage closure. Cardiovascular CT can provide important information to assess the suitability of patients for LAA interventions and guide device selection and approach. The high spatial resolution and multiplanar capability of contemporary contrast-enhanced gated multidetector cardiovascular CT render it an ideal modality for noninvasively evaluating patients before intervention and assessing patients after intervention both for complications and procedural outcome.
authors.affiliation: Radiology Department, Royal Brompton Hospital, Sydney Street, London SW3 6NP, United Kingdom; National Heart and Lung Institute, Imperial College London, London, United Kingdom.
authors.forename: Tevfik Fehmi
authors.initials: TF
authors.lastname: Ismail
authors.affiliation: National Heart and Lung Institute, Imperial College London, London, United Kingdom; Cardiac Electrophysiology Department, Royal Brompton Hospital, London, United Kingdom.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Panikker
authors.affiliation: National Heart and Lung Institute, Imperial College London, London, United Kingdom; Cardiac Electrophysiology Department, Royal Brompton Hospital, London, United Kingdom.
authors.forename: Vias
authors.initials: V
authors.lastname: Markides
authors.affiliation: National Heart and Lung Institute, Imperial College London, London, United Kingdom; Cardiac Electrophysiology Department, Royal Brompton Hospital, London, United Kingdom.
authors.forename: John P
authors.initials: JP
authors.lastname: Foran
authors.affiliation: Radiology Department, Royal Brompton Hospital, Sydney Street, London SW3 6NP, United Kingdom; National Heart and Lung Institute, Imperial College London, London, United Kingdom.
authors.forename: Simon
authors.initials: S
authors.lastname: Padley
authors.affiliation: Radiology Department, Royal Brompton Hospital, Sydney Street, London SW3 6NP, United Kingdom; National Heart and Lung Institute, Imperial College London, London, United Kingdom.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Rubens
authors.affiliation: National Heart and Lung Institute, Imperial College London, London, United Kingdom; Cardiac Electrophysiology Department, Royal Brompton Hospital, London, United Kingdom.
authors.forename: Tom
authors.initials: T
authors.lastname: Wong
authors.affiliation: Radiology Department, Royal Brompton Hospital, Sydney Street, London SW3 6NP, United Kingdom; National Heart and Lung Institute, Imperial College London, London, United Kingdom. Electronic address: e.nicol@rbht.nhs.uk.
authors.forename: Edward
authors.initials: E
authors.lastname: Nicol
mesh_terms: D020517:Atrial Appendage / Q000000981:diagnostic imaging* / Q000473:pathology; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000628:therapy; D006328:Cardiac Catheterization / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D010781:Photography; D011379:Prognosis; D011856:Radiographic Image Enhancement; D018570:Risk Assessment; D055989:Septal Occluder Device; D020521:Stroke / Q000517:prevention & control*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
keywords: Amplatzer Cardiac Plug; Atrial Fibrillation; Cardiovascular CT; Lariat; Left Atrial Appendage; Stroke; Watchman device