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首页> 外文期刊>Clinical cardiology. >Relation of left atrial appendage closure devices to topographic neighboring structures using standardized imaging by cardiac computed tomography angiography
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Relation of left atrial appendage closure devices to topographic neighboring structures using standardized imaging by cardiac computed tomography angiography

机译：心脏计算机断层造影血管造影术标准化成像后，左心耳闭合装置与周围地形的关系

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Background Although left atrial appendage (LAA) anatomy and topographic relations are well understood, little is known about the impairment of neighboring structures (NBS) by an implanted left atrial appendage closure (LAAC) device. This prospective longitudinal observational study for the first time describes distances of implanted LAA closure (LAAC) devices to NBS using a standardized imaging protocol of cardiac computed tomography angiography (cCTA). Hypothesis cCTA imaging is an eligible tool for post‐implantation evaluation of LAAC devices and their relation to neighboring structures. Methods cCTA data sets of consecutive patients 6 months after successful LAAC were acquired on a third generation dual‐source CT system and reconstructed with a slice thickness of 0.5 mm. The standardized multi‐planar reconstruction LAA occluder view for post‐implantation evaluation (LOVE) algorithm was used to measure the distances to NBS in relation to LAA morphology and implanted LAAC devices. Results A total of 48 patients (median age 80 years, 25% female) were included. Left upper pulmonary vein and circumflex artery were generally closest to occlusion devices (median 2.9 and 2.8 mm, respectively). AMPLATZER AMULET devices were closer to the mitral valve annulus than WATCHMAN devices (6.6 mm (inter quartile range [IQR] 4.9‐8.6) vs 10.9 mm (IQR 7.4‐14.0), P = 0.001). Distances to the left upper pulmonary vein were affected by LAA morphology, with cauliflower type having the closest proximity (1.7 mm [IQR 1.0‐3.4], P = 0.048). Conclusion A standardized cCTA imaging protocol is an eligible tool to accurately measure distances to NBS. Left upper pulmonary vein and circumflex artery are closest to LAAC devices and could thus be most prone to impairment.
机译：背景技术尽管人们对左心耳（LAA）的解剖结构和地形关系了解得很清楚，但对于植入的左心耳闭合（LAAC）装置对邻近结构（NBS）的损害知之甚少。这项前瞻性纵向观察研究首次描述了使用心脏计算机断层扫描血管造影（cCTA）的标准化成像协议植入的LAA闭合（LAAC）装置到NBS的距离。假设cCTA成像是用于LAAC装置植入后评估及其与邻近结构的关系的合格工具。方法在第三代双源CT系统上获得成功LAAC后连续6个月的患者cCTA数据集，并用0.5 mm的切片厚度重建。用于植入后评估（LOVE）算法的标准化多平面重建LAA封堵器视图用于测量与LAA形态和植入LAAC装置相关的NBS距离。结果共纳入48例患者，中位年龄80岁，女性25％。左上肺静脉和回旋动脉通常最靠近阻塞装置（分别为中值2.9和2.8 mm）。 AMPLATZER AMULET设备比WATCHMAN设备更靠近二尖瓣环（6.6 mm（四分位间距[IQR] 4.9-8.6）vs 10.9 mm（IQR 7.4-14.0），P = 0.001）。左上肺静脉的距离受LAA形态的影响，其中菜花类型最接近（1.7 mm [IQR 1.0-3.4]，P = 0.048）。结论标准化的cCTA成像协议是准确测量到NBS距离的合格工具。左上肺静脉和回旋动脉最靠近LAAC装置，因此最容易受损。

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