Document Detail


A novel approach to the diagnosis of left atrial appendage thrombus using contrast echocardiography and power Doppler imaging.
MedLine Citation:
PMID:  18490330     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Transesophageal echocardiography is performed routinely among patients with atrial fibrillation (AF) in order to exclude left atrial appendage (LAA) thrombus prior to cardioversion. Because assessment for LAA thrombus is dependent upon the experience of the operator and is therefore subjective, there remains a subset of patients in whom the diagnosis may not be definitive. The purpose of this report is to present a novel technique which may aid in the confirmation and/or exclusion of LAA thrombus using contrast echocardiography (CE) and power Doppler (PD) imaging. METHODS: TEE imaging of the LAA appendage was performed in 3 patients. By visual inspection, the presence of the thrombus was absent (patient one), equivocal (patient two) and definite (patient three). Contrast echocardiography with Definity and power Doppler imaging was performed to aid in the confirmation and/or exclusion of thrombus in these 3 patients. RESULTS: CE alone was useful in confirming the absence and presence of LA thrombus determined by visual inspection in patients one and three, respectively. CE in conjunction with PD imaging was useful in identifying the presence of LAA thrombus (by showing a filling defect and the absence of flow in the tip) in the patient with equivocal results by visual inspection CONCLUSION: Contrast echocardiography alone may be useful in confirming and/or excluding the presence of LAA thrombus among patients with AF. CE with PD imaging provides incremental information in aiding in the diagnosis when the conventional images are equivocal.
Authors:
Andres Ruiz-Arango; Carolyn Landolfo
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology     Volume:  9     ISSN:  1532-2114     ISO Abbreviation:  Eur J Echocardiogr     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-05-20     Completed Date:  2008-08-12     Revised Date:  2008-08-14    
Medline Journal Info:
Nlm Unique ID:  100890618     Medline TA:  Eur J Echocardiogr     Country:  England    
Other Details:
Languages:  eng     Pagination:  329-33     Citation Subset:  IM    
Affiliation:
Cardiovascular Department, Medical College of Georgia, BBR-6518 Augusta, GA 30912, USA. ararango@mcg.edu
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MeSH Terms
Descriptor/Qualifier:
Atrial Appendage*
Contrast Media
Coronary Thrombosis / ultrasonography*
Echocardiography, Transesophageal / methods*
Fluorocarbons / diagnostic use
Humans
Ultrasonography, Doppler
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Definity; 0/Fluorocarbons

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


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