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Roles of transesophageal echocardiography and cardiac computed tomography for evaluation of left atrial thrombus and associated pathology: A review and critical analysis

journal contribution
posted on 2023-05-19, 18:06 authored by Pathan, F, Hecht, H, Narula, J, Marwick, TH
Evaluation of the left atrium and left atrial appendage for the presence of thrombus prior to cardioversion and pulmonary vein isolation, and of the entire heart for embolic sources in the setting of cryptogenic stroke, has long been standard medical care. Guidelines have uniformly recommended transesophageal echocardiography (TEE) to accomplish these goals. In recent years, computed tomographic angiography has demonstrated diagnostic accuracy similar to that of TEE for the detection of thrombus. Analysis of the pertinent data and relative merits of the 2 technologies leads to the conclusions that: 1) both modalities have some unique, nonoverlapping capabilities that may dictate their use in specific situations; 2) computed tomographic angiography is a reasonable alternative to TEE when the primary aim is to exclude left atrial and left atrial appendage thrombus and in patients in whom the risks associated with TEE outweigh the benefits; and 3) both options should be discussed with the patient in the setting of shared decision making.

History

Publication title

JACC: Cardiovascular Imaging

Volume

11

Issue

4

Pagination

616-627

ISSN

1936-878X

Department/School

Menzies Institute for Medical Research

Publisher

Elsevier Inc.

Place of publication

United States

Rights statement

© 2018 by the American College of Cardiology Foundation.

Repository Status

  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified

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