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Evolving insights into the role of local shear stress in late stent failure from neoatherosclerosis formation and plaque destabilization Current Status and Future Prospects of Transcatheter Mitral Valve Replacement: JACC State-of-the-Art Review Gut microbiota dysbiosis promotes age-related atrial fibrillation by lipopolysaccharide and glucose-induced activation of NLRP3-inflammasome Detection of Device-Related Thrombosis Following Left Atrial Appendage Occlusion A Comparison Between Cardiac Computed Tomography and Transesophageal Echocardiography​: A Comparison Between Cardiac Computed Tomography and Transesophageal Echocardiography Does pulsed field ablation regress over time? A quantitative temporal analysis of pulmonary vein isolation Role of local coronary blood flow patterns and shear stress on the development of microvascular and epicardial endothelial dysfunction and coronary plaque Management and outcomes of patients with left atrial appendage thrombus prior to percutaneous closure Transseptal puncture versus patent foramen ovale or atrial septal defect access for left atrial appendage closure Rivaroxaban Is Associated With Higher Rates of Gastrointestinal Bleeding Than Other Direct Oral Anticoagulants: A Nationwide Propensity Score–Weighted Study Left Atrial Appendage Occlusion during Cardiac Surgery to Prevent Stroke

Recommandation StatementVolume 13, Issue 3, February 2020

JOURNAL:JACC: Cardiovascular Interventions Article Link

Expert Recommendations on Cardiac Computed Tomography for Planning Transcatheter Left Atrial Appendage Occlusion

K Korsholm,S Berti,JE Nielsen-Kudsk et al. Keywords: CT scanner requirements; left atrial appendage thrombus detection and measurements; contrast injection; patient preparation

ABSTRACT

Transcatheter left atrial appendage occlusion is an increasingly used alternative to oral anticoagulation in selected patients with atrial fibrillation. Pre-procedural imaging is a prerequisite to a successful intervention, with transesophageal echocardiography as the current gold standard. However, cardiac computed tomography offers improved imaging with high-quality multiplanar and 3-dimensional reconstructed images. Nevertheless, the lack of a standardized imaging protocol has slowed the adoption of cardiac computed tomography into clinical practice. On the basis of current research and expert consensus, this paper provides a protocol for the preparation, acquisition, and interpretation of cardiac computed tomographic imaging in pre-procedural planning of left atrial appendage occlusion.