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Bioprosthetic valve oversizing is associated with increased risk of valve thrombosis following TAVR Suture- or Plug-Based Large-Bore Arteriotomy Closure: A Pilot Randomized Controlled Trial Is Cardiac Diastolic Dysfunction a Part of Post-Menopausal Syndrome? From Subclinical Atherosclerosis to Plaque Progression and Acute Coronary Events Clinical Risk Factors and Atherosclerotic Plaque Extent to Define Risk for Major Events in Patients Without Obstructive Coronary Artery Disease: The Long-Term Coronary Computed Tomography Angiography CONFIRM Registry Major Bleeding Rates in Atrial Fibrillation Patients on Single, Dual, or Triple Antithrombotic Therapy 2019 ACC/AHA/ASE Advanced Training Statement on Echocardiography (Revision of the 2003 ACC/AHA Clinical Competence Statement on Echocardiography): A Report of the ACC Competency Management Committee Impact of Intravascular Ultrasound-Guided Drug-Eluting Stent Implantation on Patients With Chronic Kidney Disease: Subgroup Analysis From ULTIMATE Trial Dual Antiplatelet Therapy Duration: Reconciling the Inconsistencies The Burden of Cardiovascular Diseases Among US States, 1990-2016

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.