title: Cardiac CT Angiography (CCTA) predicts left atrial appendage occluder device size and procedure outcome.
abstract: OBJECTIVE
  To investigate the role of cardiac CT angiography (CCTA) in predicting optimal left atrial appendage (LAA) occluder size and procedure outcome.
  
  
  RESULTS
  Thirty-six patients underwent pre-procedural CCTA. CCTA and TEE LAA orifice diameters and perimeters were compared with the implanted device size. CCTA 3D configuration was correlated with procedure outcome. Watchman™ device (N = 18): diameters were 21 ± 4, 26 ± 5 and 25 ± 3 mm for TEE, CCTA and inserted device, respectively. Average perimeters were 61 ± 10, 74 ± 8 and 78 ± 11 mm for TEE, CCTA and inserted device, respectively. Better agreement with the device size was found for CCTA compared to TEE (Bland-Altman). ACP™ device (N = 15): diameters were 20 ± 5, 25 ± 4 and 23 ± 4 for TEE, CCTA and inserted device, respectively. Average perimeters were 58 ± 11, 72 ± 15 and 72 ± 13 mm for TEE, CCTA and inserted device, respectively. Excellent correlation and agreement with the device size was found for CCTA compared to TEE. CCTA perimeter >100 mm and "cactus" 3D configuration had a specificity of 96 and 81% respectively for procedure failure.
  
  
  CONCLUSIONS
  CCTA LAA ostial perimeter predicted better the optimal occluder size as compared with the currently used LAA TEE diameter. Moreover, CCTA 3D data may help in predicting potential complications.
authors.affiliation: Department of Diagnostic Imaging, Chaim Sheba Medical Center, 52621, Ramat Gan, Israel. Orly.Goitein@sheba.health.gov.il.|The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Orly.Goitein@sheba.health.gov.il.
authors.forename: Orly
authors.identifier: http://orcid.org/0000-0003-2027-874X
authors.initials: O
authors.lastname: Goitein
authors.affiliation: Heart Center, Chaim Sheba Medical Center, 52621, Ramat Gan, Israel.|The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Noam
authors.initials: N
authors.lastname: Fink
authors.affiliation: Heart Center, Chaim Sheba Medical Center, 52621, Ramat Gan, Israel.|The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ilan
authors.initials: I
authors.lastname: Hay
authors.affiliation: Department of Diagnostic Imaging, Chaim Sheba Medical Center, 52621, Ramat Gan, Israel.|The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Elio
authors.initials: E
authors.lastname: Di Segni
authors.affiliation: Heart Center, Chaim Sheba Medical Center, 52621, Ramat Gan, Israel.|The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Victor
authors.initials: V
authors.lastname: Guetta
authors.affiliation: Department of Surgery C, Chaim Sheba Medical Center, 52621, Ramat Gan, Israel.|The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Goitein
authors.affiliation: Department of Diagnostic Imaging, Chaim Sheba Medical Center, 52621, Ramat Gan, Israel.|Heart Center, Chaim Sheba Medical Center, 52621, Ramat Gan, Israel.|The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Yafim
authors.initials: Y
authors.lastname: Brodov
authors.affiliation: Department of Diagnostic Imaging, Chaim Sheba Medical Center, 52621, Ramat Gan, Israel.|The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Eli
authors.initials: E
authors.lastname: Konen
authors.affiliation: Heart Center, Chaim Sheba Medical Center, 52621, Ramat Gan, Israel.|The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Glikson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020517:Atrial Appendage / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D016279:Atrial Function, Left; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography / Q000379:methods*; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008297:Male; D061330:Multidetector Computed Tomography; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D012307:Risk Factors; D055989:Septal Occluder Device; D016896:Treatment Outcome
keywords: CCTA; LAA 3D; LAA occluder device