Cardiac imaging for assessment of left atrial appendage stasis and thrombosis

  title={Cardiac imaging for assessment of left atrial appendage stasis and thrombosis},
  author={Jorge E. Romero and Jie Jane Cao and Mario J. Garcia and Cynthia C. Taub},
  journal={Nature Reviews Cardiology},
Atrial fibrillation (AF) is the most-common arrhythmia in the elderly population (age >65 years). The left atrial appendage (LAA) is the main location of thrombus formation, predominantly in patients with nonvalvular AF. This Review is focused on the pathophysiology, assessment, and clinical implications of stasis (or spontaneous echocardiographic contrast; SEC) and thrombus formation in the LAA. The gold-standard modality for assessment of SEC and thrombus in the LAA is echocardiography… 

Multimodality imaging of left atrium in patients with atrial fibrillation.

Echocardiography for assessment of left atrial stasis and thrombosis – three cases report

We report three cases of chronic atrial fibrillation without anticoagulation admitted for acute lower limb ischemia in which embolic source was left atrial appendage (LAA) thrombus revealed only by

Biomarkers for Predicting Left Atrial or Left Atrial Appendage Thrombus in Anticoagulated Patients with Nonvalvular Atrial Fibrillation

In anticoagulation patients with NVAF, elevated NT-proBNP and RDW are related to LA/LAA thrombus and might be considered as useful prognostic markers in the management and treatment of NVAF patients.

Detection of left atrial appendage thrombus by dual-energy computed tomography-derived imaging biomarkers in patients with atrial fibrillation

The dual-energy CT-derived iodine concentration and the Zeff showed better diagnostic performance than the conventional HU in early-phase cardiac CT in detecting LAA thrombus and differentiating the throm Bus from the circulatory stasis, however, these results need to be validated in large-cohort studies with late-phase images.

Circulatory Stasis or Thrombus in Left Atrial Appendage, An Easy Diagnostic Solution

Multidetector computed tomography scanning in the prone position differentiates circulatory stasis and LAA thrombus, is clinically useful for detecting and ruling out LAAThrombi, and may be an alternative to TEE as a diagnostic tool.

State-of-the-Art CT Imaging of the Left Atrium

The left atrium has been proposed as a barometer of cardiac function and cardiovascular risk and has become an indispensable tool in the electrophysiology laboratory in the guidance of complex procedures, including trans-catheter pulmonary vein isolation in the treatment of drug-refractory atrial fibrillation.

Accuracy of cardiac CT in evaluating severity of left atrial appendage spontaneous echo contrast: comparison with transesophageal echocardiography

Although CCT showed limited diagnostic accuracy for grade 1 LAASEC, grade ≥ 2 LAAS EC could be excluded when there was no LAA filling defect on first-phase CCT, and TEE can be avoided.

Pre- and Postprocedural CT of Transcatheter Left Atrial Appendage Closure Devices.

Transcatheter left atrial appendage closure is an alternative to long-term anticoagulation therapy in selected patients with nonvalvular atrial fibrillation who have an increased risk for stroke and CT has emerged as a less-invasive alternative to TEE for pre- and postprocedural imaging.

Left Atrial Appendage Mechanical Exclusion

Left atrial appendage (LAA) mechanical exclusion is being investigated for nonpharmacologic stroke risk reduction in selected patients with atrial fibrillation. There are multiple potential



Comprehensive left atrial appendage optimization of thrombus using surface echocardiography: the CLOTS multicenter pilot trial.

  • J. SallachS. Puwanant A. Klein
  • Medicine
    Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
  • 2009

Detection of Left Atrial Appendage Thrombus by Cardiac Computed Tomography in Patients With Atrial Fibrillation: A Meta-Analysis

Cardiac computed tomography, particularly when delayed imaging is performed, is a reliable alternative to TEE for the detection of LA/LAA thrombi/clot, avoiding the discomfort and risks associated with TEE.

Left atrial appendage thrombi in stroke patients: detection with two-phase cardiac CT angiography versus transesophageal echocardiography.

Two-phase 64-section cardiac CT angiography is a noninvasive sensitive modality for detecting LAA thrombi and differentiating thrombus from circulatory stasis in stroke patients.

Thrombus in the left atrial appendage in stroke patients: detection with cardiac CT angiography--a preliminary report.

Sixty-four-section cardiac CT angiography is a noninvasive and sensitive modality for detecting thrombi in the LAA of stroke patients and has the potential to become a usefulmodality for detection of intracardiac thrombus.

Cardioembolic stroke: dual-energy cardiac CT for differentiation of left atrial appendage thrombus and circulatory stasis.

Dual-energy cardiac CT is a highly sensitive modality for detecting LAA thrombus and for differentiatingThrombus from SEC in patients with stroke, using transesophageal echocardiography as the reference standard.

Comparison of Magnetic Resonance Imaging and Transesophageal Echocardiography in Detection of Thrombus in the Left Atrial Appendage

MRI is a noninvasive and reproducible modality for thrombus detection in the LAA of patients with nonrheumatic continuous atrial fibrillation and previous cardioembolic stroke.

Use of transesophageal contrast echocardiography for excluding left atrial appendage thrombi in patients with atrial fibrillation before cardioversion.

The application of echo contrast may facilitate the TEE exclusion of LA appendage thrombi and, hence, improve the safety of TEE-guided cardioversion.