OBJECTIVE

To evaluate the effect of preoperative contrast-enhanced cardiac computed tomography on the outcomes and technical success of endovascular isolation of the left atrial appendage (LAA).

MATERIAL AND METHODS

A retrospective study included 120 patients with non-valvular atrial fibrillation and high thrombotic risk who underwent transcatheter implantation of the LAA occluder between 2011 and 2017. Patients were divided into 2 groups (no CT in 74 cases, preoperative CT in 46 patients). Clinical efficacy, safety and technical parameters of LAA isolation were analyzed. The overall prospective follow-up period was 3 years. The endpoints of efficacy and safety were evaluated within 6 months.

RESULTS

Surgery time was significantly lower (70 vs. 57.5 min, p<0.001) and residual blood flow >5 mm at the end of procedure was significantly less common (9.5 vs. 0%, p<0.05) in patients with preoperative CT. There were no differences in combined endpoint of clinical efficacy throughout 6 months (p=0.88). The incidence of major and minor bleedings within 6 months was comparable (p=0.13).

CONCLUSION

Preoperative cardiac CT reduces surgery time and incidence of significant residual leakage in early postoperative period. In addition, CT is valuable to exclude LAA thrombosis in case of unclear data of echocardiography.