Document Detail


Real time 3-dimensional transesophageal echocardiography is more specific than 2-dimensional TEE in the assessment of left atrial appendage thrombosis.
MedLine Citation:
PMID:  22660219     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background. In patients indicated for detection of intraatrial thrombus (T), 2-dimensional transesophageal echocardiography (2DTEE) is routinely used but differentiation between T and trabeculae or artifacts in the left atrial appendage (LAA) is often difficult. Aims. To compare the diagnostic value of real time 3D-transesophageal echocardiography (RT3DTEE) and 2DTEE in the assessment of LAA thrombosis. Patients and Methods. One hundred and ten consecutive patients (73M, aged 64+-13) were examined by 2DTEE. In terms of possible T, individual pts were diagnosed as negative (N2), uncertain trabecular finding (U2), other/artifacts (O2), and clearly positive (T2). The RT3DTEE was then applied and the categorization repeated (N3,U3,O3 and T3, resp.). Finally, the operator decided whether the RT3DTEE A: had an additional diagnostic value, and/or B: changed the definite diagnosis of thrombosis. Results. N2:71; U2:17; O2:19; T2:3; N3:97; U3:1; O3:12; T3:0.Ad A/ RT3DTEE enabled us to refine or change the diagnosis in 26/110 cases. 17 pts were switched from group U2 to N3, 7:O2-N3 and 2:T2-N3. 12 pts from O2 and 1 pt from T2 remained unclarified. Ad B/ Diagnoses were changed in 6 patients after RT3DTEE. A very suspicious T2 was found in 3 patients. In 1, the finding was requalified definitely as musculi pectinati. In the second patient, the finding was re-categorized as just a spontaneous echocontrast without T. In another 4 patients, T in LAA was definitely excluded after RT3DTEE (1 patient switched from U2 to N3, 3 from O2 to N3). In another 13, the findings remained unclear, mostly because of poor quality image. No real thrombus was found in this study. Conclusion. RT3DTEE provides additional information, which may be helpful in the differentiation of thrombus from other findings. It is particularly useful in the identification of muscular trabeculae in the left atrial appendage.
Authors:
Dan Marek; David Vindis; Eva Kocianova
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-30
Journal Detail:
Title:  Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia     Volume:  -     ISSN:  1213-8118     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-6-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101140142     Medline TA:  Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Internal Medicine I - Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic. dan.marek@fnol.cz.
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