Assessment of left atrial appendage by Live Three-Dimensional Echocardiography

Early experience and comparison with transesophageal echocardiography

Ildiko Agoston, Tianrong Xie, Frank L. Tiller, Atiar M. Rahman, Masood Ahmad

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Background: Live Three-Dimensional Echocardiography (L3D, Sonos 7500, Philips) has the potential to visualize all cardiac structures including left atrial appendage (LAA). We tested the feasibility of evaluating LAA by L3D and compared the findings to transthoracic echocardiography (2D) and in a subset of patients with transesophageal echocardiography (TEE). Methods: L3D images were obtained in 204 consecutive patients referred for routine 2D or TEE. We performed wide-angled acquisitions from parasternal and apical views. TomTec system (4D Cardio-view, RT 1.2) was used to visualize LAA from multiple vantage points. Results: LAA was adequately visualized by L3D in 139 of 204 (68.1%) patients. L3D visualization was dependent on image quality, suboptimal in 100 and diagnostic in 104 patients. Overall, LAA was visualized in 93 (45.5%) patients by 2D compared to 139 (68.1%) by L3D (P < 0.0001). In 100 patients with suboptimal image quality by L3D, LAA visualization was 16% by 2D and 35% by L3D, whereas in 104 patients with diagnostic images, LAA was visualized in 77 (74%) by 2D and in all 104 (100%) patients by L3D (P < 0.0001). In 37 patients referred for transesophageal echocardiography (TEE), live three-dimensional echocardiography (L3D) visualized left atrial appendage (LAA) in 34 patients with diagnostic image quality. Eight patients with LAA thrombi on TEE had thrombi detected by L3D as well. All patients with LAA thrombus had enlarged LA by both 2D and TEE.Conclusions: L3D is a promising technique in evaluation of LAA with and without thrombi. In patients with good quality transthoracic images L3D may be used as a screening tool in assessment of LAA.

Original languageEnglish (US)
Pages (from-to)127-132
Number of pages6
JournalEchocardiography
Volume23
Issue number2
DOIs
StatePublished - Feb 2006

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Three-Dimensional Echocardiography
Atrial Appendage
Transesophageal Echocardiography
Thrombosis
Echocardiography

Keywords

  • Left atrial appendage
  • Three-dimensional echocardiography
  • Transesophageal echocardiography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Assessment of left atrial appendage by Live Three-Dimensional Echocardiography : Early experience and comparison with transesophageal echocardiography. / Agoston, Ildiko; Xie, Tianrong; Tiller, Frank L.; Rahman, Atiar M.; Ahmad, Masood.

In: Echocardiography, Vol. 23, No. 2, 02.2006, p. 127-132.

Research output: Contribution to journalArticle

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abstract = "Background: Live Three-Dimensional Echocardiography (L3D, Sonos 7500, Philips) has the potential to visualize all cardiac structures including left atrial appendage (LAA). We tested the feasibility of evaluating LAA by L3D and compared the findings to transthoracic echocardiography (2D) and in a subset of patients with transesophageal echocardiography (TEE). Methods: L3D images were obtained in 204 consecutive patients referred for routine 2D or TEE. We performed wide-angled acquisitions from parasternal and apical views. TomTec system (4D Cardio-view, RT 1.2) was used to visualize LAA from multiple vantage points. Results: LAA was adequately visualized by L3D in 139 of 204 (68.1{\%}) patients. L3D visualization was dependent on image quality, suboptimal in 100 and diagnostic in 104 patients. Overall, LAA was visualized in 93 (45.5{\%}) patients by 2D compared to 139 (68.1{\%}) by L3D (P < 0.0001). In 100 patients with suboptimal image quality by L3D, LAA visualization was 16{\%} by 2D and 35{\%} by L3D, whereas in 104 patients with diagnostic images, LAA was visualized in 77 (74{\%}) by 2D and in all 104 (100{\%}) patients by L3D (P < 0.0001). In 37 patients referred for transesophageal echocardiography (TEE), live three-dimensional echocardiography (L3D) visualized left atrial appendage (LAA) in 34 patients with diagnostic image quality. Eight patients with LAA thrombi on TEE had thrombi detected by L3D as well. All patients with LAA thrombus had enlarged LA by both 2D and TEE.Conclusions: L3D is a promising technique in evaluation of LAA with and without thrombi. In patients with good quality transthoracic images L3D may be used as a screening tool in assessment of LAA.",
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