Percutaneous interventions for left atrial appendage exclusion: Options, assessment, and imaging using 2D and 3D echocardiography

Nina C. Wunderlich, Roy Beigel, Martin J. Swaans, Siew Yen Ho, Robert J. Siegel*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Percutaneous left atrial appendage (LAA) exclusion is an evolving treatment to prevent embolic events in patients with nonvalvular atrial fibrillation. In the past few years multiple percutaneous devices have been developed to exclude the LAA from the body of the left atrium and thus from the systemic circulation. Two- and 3-dimensional transesophageal echocardiography (TEE) is used to assess the LAA anatomy and its suitability for percutaneous closure to select the type and size of the closure device and to guide the device implantation procedure in conjunction with fluoroscopy. In addition, 2- and 3-dimensional TEE is also used to assess the effectiveness of device implantation acutely and on subsequent follow-up examination. Knowledge of the implantation options that are currently available along with their specific characteristics is essential for choosing the appropriate device for a given patient with a specific LAA anatomy. We present the currently available LAA exclusion devices and the echocardiographic imaging approaches for evaluation of the LAA before, during, and after LAA occlusion.

Original languageEnglish
Pages (from-to)472-488
Number of pages17
JournalJACC: Cardiovascular Imaging
Volume8
Issue number4
DOIs
StatePublished - 1 Apr 2015

Funding

FundersFunder number
Philips Ultrasound

    Keywords

    • 2D echocardiography
    • 3D echocardiography
    • left atrial appendage
    • percutaneous closure

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