Prediction of Left Atrial Appendage Morphological Evaluation by Left Atrial CT Imaging for Residual Leakage After Left Atrial Appendage Closure in Atrial Fibrillation
10.3969/j.issn.1005-5185.2025.02.006
- VernacularTitle:术前左心房CT成像左心耳形态学评估对房颤患者左心耳封堵术后发生残余漏的预测价值
- Author:
Jianying ZHANG
1
;
Xuelian GAO
;
Chaoqiang ZENG
;
Fuzhou ZHANG
;
Hui WANG
Author Information
1. 首都医科大学附属北京安贞医院南充医院·四川南充市中心医院CT/MRI室,四川 南充 637000
- Publication Type:Journal Article
- Keywords:
Atrial fibrillation;
Tomography,X-ray computed;
Heart atria;
Left atrial appendage closure;
The Watchman device;
Residual leakage
- From:
Chinese Journal of Medical Imaging
2025;33(2):141-146,164
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To evaluate the predictive value of left atrial appendage(LAA)morphological assessment by preoperative left atrial CT imaging in the risk of peri-device leak(PDL)after left atrial appendage occlusion(LAAO)in atrial fibrillation.Materials and Methods Seventy-one patients with atrial fibrillation who successfully underwent LAAO in Nanchong Central Hospital from January 2020 to February 2024 were retrospectively analyzed.According to the results of left atrial CT imaging after LAAO,all patients were divided into the PDL group(n=26)and the non-PDL group(n=45).The long diameter,short diameter,long diameter/short diameter ratio,area,perimeter of both the LAA orifice and landing area,and LAA length and LAA depth were compared between the two groups.Univariate and multivariate Logistic regression analysis were used to explore the risk factors leading to the differences between the two groups.Results The long diameter,long diameter/short diameter ratio,area,perimeter of both the LAA orifice and landing area in the PDL group were statistically higher than those in the non-PDL group(t/Z=4.952,-5.570,-2.912,3.191,6.757,-6.462,-3.318,3.733,all P<0.05).The LAA orifice short diameter,LAA length,LAA depth and the short diameter of landing area in the PDL group were higher than those in the non-PDL group,but there were no statistically significant differences between the two groups(t/Z=-1.773,1.765,1.509,-1.415,all P>0.05).Univariate Logistic regression analysis showed that the long diameter,long diameter/short diameter ratio,area and perimeter of LAA orifice and landing area before operation were correlated with postoperative PDL(P<0.05).Multivariate Logistic regression analysis showed that,the long diameter/short diameter ratio of LAA landing area was an independent risk factor for postoperative PDL.Conclusion Preoperative evaluation of the morphology of LAA orifice and landing zone by left atrial CT imaging can predict the occurrence of PDL after LAAO in atrial fibrillation in advance.When the long/short diameter of the landing area is large,it is necessary to be highly alert to the occurrence of PDL,which provides a basis for selecting and customizing the occluder before LAAO in patients with atrial fibrillation.
