Document Detail

Imaging of thrombi and assessment of left atrial appendage function: a prospective study comparing transthoracic and transoesophageal echocardiography.
MedLine Citation:
PMID:  9922358     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To compare the value of current transthoracic echocardiographic systems and transoesophageal echocardiography for assessing left atrial appendage function and imaging thrombi. DESIGN: Single blind prospective study. Patients were first investigated by transthoracic echocardiography and thereafter by a second investigator using transoesophageal echocardiography. The feasibility of imaging the left atrial appendage, recording its velocities, and identifying thrombi within the appendage were determined by both methods. PATIENTS: 117 consecutive patients with a stroke or transient neurological deficit. SETTING: Tertiary cardiac and neurological care centre. RESULTS: Imaging of the complete appendage was feasible in 75% of the patients by transthoracic echocardiography and in 95% by transoesophageal echocardiography. Both methods were concordant for the detection of thrombi in 10 cases. Transoesophageal echocardiography revealed two additional thrombi. In one of these patients, transthoracic echocardiography was not feasible and in the other the thrombus had been missed by transthoracic examination. In patients with adequate transthoracic echogenicity, the specificity and sensitivity of detecting left atrial appendage thrombi were 100% and 91%, respectively. Recording of left atrial appendage velocities by transthoracic echocardiography was feasible in 69% of cases. None of the patients with a velocity > 0.3 m/s had left atrial appendage thrombi. In the one patient in whom transthoracic echocardiographic evaluation missed a left atrial appendage thrombus, the peak emptying velocity of the left atrial appendage was 0.25 m/s. CONCLUSIONS: A new generation echocardiographic system allows for the transthoracic detection of left atrial appendage thrombi and accurate determination of left atrial appendage function in most patients with a neurological deficit.
H Omran; W Jung; R Rabahieh; P Wirtz; H Becher; S Illien; R Schimpf; B Lüderitz
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  81     ISSN:  1355-6037     ISO Abbreviation:  Heart     Publication Date:  1999 Feb 
Date Detail:
Created Date:  1999-06-03     Completed Date:  1999-06-03     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  192-8     Citation Subset:  AIM; IM    
Department of Medicine, Division of Cardiology, University of Bonn, Sigmund-Freud-Str 25, 53105 Bonn, Germany.
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MeSH Terms
Atrial Function, Left*
Echocardiography, Transesophageal*
Heart Atria / physiopathology,  ultrasonography*
Middle Aged
Prospective Studies
Sensitivity and Specificity
Single-Blind Method
Thromboembolism / physiopathology,  ultrasonography*

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