Cardiac CT, TEE Essential for Post-LAAO Evaluation

Background: The left atrial appendage occlusion (LAAO) device is increasingly used for prevention of ischemic strokes from clots forming in the heart. However, this device can rarely cause clot formation, which can increase the risk for stroke, called "device-related thrombus" (DRT). Since detection of DRT is critical for appropriate patient management, imaging studies to accurately detect this complication are essential. Objective: To describe the findings of DRT from the LAAO device detected on cardiac CT and transesophageal echocardiography (TEE). Design: Case reports of 7 patients who had LAAO devices implanted, and post-implantation cardiac CT and TEE evaluations are presented. Methods: The criteria used for DRT on TEE studies required an echodensity on the device surface not explained by artifact or normal device healing. Cardiac CT identified changes called hypoattenuated thickening (HAT), which is hypo-attenuated thickening along the surface of the LAAO device. Low-grade HAT more...