MethodsTransthoracic Echocardiographic Predictors of Left Atrial Appendage Thrombus
Section snippets
Methods
This retrospective study consisted of patients who underwent TEE at the Cleveland Clinic Foundation from November 1995 to March 2003 to exclude LAA thrombi after embolic events or before cardioversion for atrial fibrillation or atrial flutter. Examination of the database revealed 10,753 patients who underwent TEE during this time period for the stated indications. Inclusion in the study also required a TTE examination <2 weeks before TEE as well as being ≥18 years of age. Although 10,753
Results
TEE identified 199 LAA thrombi (5.3%) in the 3,768 patients who underwent TEE to evaluate for potential sources of embolism before cardioversion. Baseline clinical and echocardiographic characteristics categorized according to the presence of LAA thrombus are listed in Table 1.
Cardiac chamber size and function were predictive of LAA thrombi. Approximately 59.2% of patients with LAA thrombi had LV dysfunction, compared with 34.8% of patients without LAA thrombi (p <0.0001). Fifty-two percent of
Discussion
This study of patients presenting for TEE after embolic events or before planned cardioversion for atrial fibrillation or atrial flutter attempted to define a patient population with a low risk for LAA thrombus on the basis of TTE findings. The study also aimed to determine whether certain TTE characteristics could be used to predict the presence of LAA thrombi as identified by TEE. The population of patients found to be at the lowest risk for LAA thrombi were those with structurally normal
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