Left Atrial Appendage Studied by Computed Tomography to Help Planning for Appendage Closure Device Placement
Left Atrial Appendage Studied by Computed Tomography to Help Planning for Appendage Closure Device Placement
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DOI：
10.1111/j.1540-8167.2010.01814.x
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发表时间：
2010-09-01
影响因子：
2.7
通讯作者：
Natale, Andrea
中科院分区：
文献类型：
--
作者：
Wang, Yan;Di Biase, Luigi;Natale, Andrea
方法：对612例患有或不患有房颤（AF）的患者进行心脏CT检查。结果：左心耳的一般形态分类包括ChickenWing型（18.3%）、WindSock型（46.7%）、Cauliflower型（29.1%）和Cactus型（5.9%）。 LAA与左上肺静脉（LSPV）的解剖关系分为高型（高于LSPV，30.2％）、中型（与LSPV平行，58.1％）和低型（低于LSPV，11.7％）。 LAA口可分为5种类型，包括椭圆形（68.9%）、足状（10%）、三角形（7.7%）、水滴状（7.7%）和圆形（5.7%）。二维 (2D) 正交法对于确定 LAA 孔口显然不准确，因为测量结果通常与 LAA 孔口不平行。二维倾斜法测定左心耳口大小的重复性优于三维法。根据左心耳口周长计算的直径优于直接测量左心耳口直径来选择封堵器。结论：左心耳和左心耳口的形态极其复杂和异质。 64 通道心脏 CT 可以协助术前计划左心耳封堵器的放置。根据周长计算出的左心耳口直径是确定左心耳封堵器尺寸的最佳参数。 （《心血管电生理杂志》，第 21 卷，第 973-982 页，2010 年 9 月）。
Methods: In 612 cases of patients with or without atrial fibrillation (AF), a cardiac CT study was performed.Results: The classification of general LAA morphology included ChickenWing type (18.3%), WindSock (46.7%), Cauliflower type (29.1%), and Cactus type (5.9%). Anatomical relationship of the LAA to the left superior pulmonary vein (LSPV) were classified as high type (superior to LSPV, 30.2%), mid type (parallel to LSPV, 58.1%), and low type (inferior to LSPV, 11.7%). LAA ostium could be classified into 5 types including oval (68.9%), foot-like (10%), triangular (7.7%), water drop-like (7.7%), and round (5.7%). Two-dimensional (2D) orthogonal method was obviously not accurate for determining the LAA orifice because the measurement was often unparallel to the LAA orifice. Two-dimensional oblique method was better than 3-dimensional method in reproducibility to determine the size of LAA ostium. The diameter calculated from the perimeter of the LAA ostium was superior to the diameter from direct measurement of the LAA ostium for selecting the occluder.Conclusion: The morphology of the LAA and the LA ostium are extremely complex and heterogeneous. Sixty-four-channel cardiac CT could assist preoperative planning of LAA closure device placement. The diameter of the LAA ostium calculated from the perimeter is the best parameter for sizing the LAA occluder. (J Cardiovasc Electrophysiol, Vol. 21, pp. 973-982, September 2010).