Document Detail

Real-time three-dimensional transesophageal echocardiography of the left atrial appendage: initial experience in the clinical setting.
MedLine Citation:
PMID:  19041579     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The aim of this study was to determine the feasibility and accuracy of a new real-time 3-dimensional (RT3D) matrix-array transesophageal echocardiographic probe for the determination of left atrial appendage (LAA) geometry. METHODS: Sixty-six consecutive patients (mean age, 53 +/- 17 years) referred for 2-dimensional (2D) transesophageal echocardiography (TEE) underwent additional RT3D TEE. The feasibility of RT3D TEE for LAA geometry was studied in the first 37 patients, and 2D and RT3D transesophageal echocardiographic quantification of the LAA were compared in the subsequent 29 patients. The LAA orifice diameter and depth were measured using biplane 2D TEE, and LAA orifice area was calculated as an ellipse. LAA orifice area and depth were measured in 3D and correlated to 2D measurement and were also correlated to 64-slice cardiac computed tomography (CT) in 8 patients. RESULTS: All 66 patients underwent RT3D matrix-array TEE without complication. In the feasibility study, the LAA was well visualized in 95%. In the quantitation study, 2D TEE underestimated LAA orifice area compared with 3D imaging (3.1 +/- 1.3 vs 4.2 +/- 2.2 cm(2); r = 0.55). LAA depth by 2D and 3D imaging were well correlated (3.7 +/- 0.7 vs 3.4 +/- 0.7 cm; r = 0.77). LAA orifice area on CT was well correlated with area on 3D TEE (r = 0.98) but not with area 2D TEE (r = 0.13). Bland-Altman analysis demonstrated that 2D TEE systematically underestimated LAA orifice area compared with 3D TEE (mean bias, -1.0 cm(2), with wide limits of agreement [-4.6 to 2.6 cm(2)]). In the 8 patients who underwent both 3D TEE and CT, the mean bias was 0.15 cm(2), with narrow limits of agreement (-0.50 to 0.20 cm(2)). CONCLUSIONS: RT3D TEE for the visualization and quantitative analysis of LAA orifice area is feasible and correlates well with 64-slice cardiac CT.
Sanjiv J Shah; Dianna M E Bardo; Lissa Sugeng; Lynn Weinert; Joseph A Lodato; Bradley P Knight; John J Lopez; Roberto M Lang
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  21     ISSN:  1097-6795     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-01     Completed Date:  2009-02-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1362-8     Citation Subset:  IM    
Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA.
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MeSH Terms
Aged, 80 and over
Atrial Appendage / ultrasonography*
Computer Systems
Echocardiography, Three-Dimensional / instrumentation*,  methods*
Echocardiography, Transesophageal / instrumentation*,  methods*
Equipment Design
Equipment Failure Analysis
Middle Aged
Pilot Projects
Reproducibility of Results
Sensitivity and Specificity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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