Journal of Cardiovascular Computed Tomography
Volume 2, Issue 3 , Pages 164-171 , May 2008

Prevalence of left atrial appendage pseudothrombus filling defects in patients with atrial fibrillation undergoing coronary computed tomography angiography

  • Farhood Saremi, MD

      Affiliations

    • Department of Radiological Sciences, University of California Irvine, UCI Medical Center, 101 The City Drive, Route 140, Orange, CA 92868-3298, USA
    • Corresponding Author InformationCorresponding author.
  • ,
  • Stephanie Channual, BS

      Affiliations

    • Department of Radiological Sciences, University of California Irvine, UCI Medical Center, 101 The City Drive, Route 140, Orange, CA 92868-3298, USA
  • ,
  • Swaminatha V. Gurudevan, MD

      Affiliations

    • Department of Cardiology, University of California Irvine, UCI Medical Center, 101 The City Drive, Route 140, Orange, CA 92868-3298, USA
  • ,
  • Jagat Narula, MD, PhD

      Affiliations

    • Department of Cardiology, University of California Irvine, UCI Medical Center, 101 The City Drive, Route 140, Orange, CA 92868-3298, USA
  • ,
  • Amir Abolhoda, MD

      Affiliations

    • Department of Cardiothoracic Surgery, University of California Irvine, UCI Medical Center, 101 The City Drive, Route 140, Orange, CA 92868-3298, USA

Received 22 August 2007 ,Accepted 27 February 2008.

References 

  1. Manning WJ, Weintraub RM, Waksmonski CA, Haering JM, Rooney PS, Maslow AD, et al. Accuracy of transesophageal echocardiography for identifying left atrial thrombi: a prospective, intraoperative study. Ann Intern Med. 1995;123:817–822
  2. Agmon Y, Khandheria BK, Gentile F, Seward JB. Echocardiographic assessment of the left atrial appendage. J Am Coll Cardiol. 1999;34:1867–1877
  3. Vincelj J, Sokol I, Jaksić O. Prevalence and clinical significance of left atrial spontaneous echo contrast detected by transesophageal echocardiography. Echocardiography. 2002;19(4):319–324
  4. von der Recke G, Schmidt H, Illien S, Lüderitz B, Omran H. Use of transesophageal contrast echocardiography for excluding left atrial appendage thrombi in patients with atrial fibrillation before cardioversion. J Am Soc Echocardiogr. 2002;15(10 Pt 2):1256–1261
  5. Tomoda H, Hoshiai M, Tagawa R, Koide S, Kawada S, Shotsu A, et al. Evaluation of left atrial thrombus with computed tomography. Am Heart J. 1980;100:306–310
  6. Kitayama H, Kiuchi K, Endo T, Hayakawa H. Value of cardiac ultrafast computed tomography for detecting right atrial thrombi in chronic atrial fibrillation. Am J Cardiol. 1997;79:1292–1295
  7. Nakanishi T, Hamada S, Takamiya M, Naito H, Imakita S, Yamada N, et al. A pitfall in ultrafast CT scanning for the detection of left atrial thrombi. J Comput Assist Tomogr. 1993;17:42–45
  8. Tani T, Yamakami S, Matsushita T, Okamoto M, Toyama J, Suzuki S, et al. Usefulness of electron beam tomography in the prone position for detecting atrial thrombi in chronic atrial fibrillation. J Comput Assist Tomogr. 2003;27(1):78–84
  9. Mohrs OK, Nowak B, Petersen SE, Welsner M, Rubel C, Magedanz A, et al. Thrombus detection in the left atrial appendage using contrast-enhanced MRI: a pilot study. AJR Am J Roentgenol. 2006;186(1):198–205
  10. Raggi P, Daniels M, Shanoudy H, Jarmukli NF. MRI misinterpretation of spontaneous echo-contrast as a large left atrial thrombus. Int J Card Imaging. 1996;12:85–88
  11. Daniel WG, Mugge A. Transesophageal echocardiography. N Engl J Med. 1995;332:1268–1279
  12. Mollet NR, Cademartiri F, van Mieghem CA, Runza G, McFadden EP, Baks T, et al. High-resolution spiral computed tomography coronary angiography in patients referred for diagnostic conventional coronary angiography. Circulation. 2005;112:2318–2323
  13. Jongbloed MR, Dirksen MS, Bax JJ, Boersma E, Geleijns K, Lamb EE, et al. Atrial fibrillation: multidetector row CT of pulmonary vein anatomy prior to radiofrequency catheter ablation--initial experience. Radiology. 2005;234(3):702–709
  14. Budoff MJ, Achenbach S, Fayad Z, Berman DS, Poon M, Taylor AJ, et al. Task Force 12: training in advanced cardiovascular imaging (computed tomography): endorsed by the American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Atherosclerosis Imaging and Prevention, and Society of Cardiovascular Computed Tomography. J Am Coll Cardiol. 2006;47(4):915–920
  15. Saremi F, Krishnan S. Cardiac conduction system: anatomical landmarks relevant to interventional electrophysiology techniques demonstrated by 64 MDCT. Radiographics. 2007;27(6):1539–1565discussion 1566–7
  16. Pollick C, Taylor D. Assessment of left atrial appendage function by transesophageal echocardiography (Implications for the development of thrombus). Circulation. 1991;84:223–231
  17. Subramaniam B, Riley MF, Panzica PJ, Manning WJ. Transesophageal echocardiographic assessment of right atrial appendage anatomy and function: comparison with the left atrial appendage and implications for local thrombus formation. J Am Soc Echocardiogr. 2006;19(4):429–433
  18. Ho SY, Anderson RH, Sanchez-Quintana D. Atrial structure and fibres: morphologic bases of atrial conduction. Cardiovasc Res. 2002;54:325–336
  19. Ernst G, Stöllberger C, Abzieher F, Veit-Dirscherl W, Bonner E, Bibus B, et al. Morphology of the left atrial appendage. Anat Rec. 1995;242:553–561
  20. Heist EK, Refaat M, Danik SB, Holmvang G, Ruskin JN, Mansour M. Analysis of the left atrial appendage by magnetic resonance angiography in patients with atrial fibrillation. Heart Rhythm. 2006;3(11):1319–1320
  21. Ohyama H, Hosomi N, Takahashi T, Mizushige K, Osaka K, Kohno M, et al. Comparison of magnetic resonance imaging and transesophageal echocardiography in detection of thrombus in the left atrial appendage. Stroke. 2003;34:2436–2439

 Conflict of interest: The authors report no conflicts of interest.

PII: S1934-5925(08)00061-0

doi: 10.1016/j.jcct.2008.02.012

Journal of Cardiovascular Computed Tomography
Volume 2, Issue 3 , Pages 164-171 , May 2008