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    Cardiology

    Imaging Support from 3D TEE in Left Atrial Appendage Closures

    4min
    Peter Jaret
    Published on August 24, 2017

    A case study from Elisabeth Hospital Essen

    The anatomy of the left atrial appendage is unique to each patient.
    Fig. 2 and 3: Baseline assessment with 2D TEE reveals a “broccoli”-type LAA.

    At this point, it was decided that the WATCHMAN cardiac procedure was not appropriate for this kind of anatomy.

    Fig. 4: Real-time 3D TEE with color Doppler to accurately evaluate flow in the LAA.

    Using 2D TEE with fluoroscopy guidance, the cardiologist advanced the device through the transseptal puncture into the left atrium and positioned it at the orifice of the LAA.
    Fig. 5: Fluoroscopy shows the WATCHMAN device has not successfully sealed the LAA.
    Thomas Schmitz, MDHead of the cardiac catheter laboratory, Elisabeth Hospital Essen

    “In the past, we performed our LAA closure procedures with fluoroscopy and 2D TEE. Today, we find that real-time 3D TEE with color Doppler makes device sizing and implantation easier, which results in more effective LAAC therapy.”

    Thomas Schmitz, MD
    Head of the cardiac catheter laboratory, Elisabeth Hospital Essen

    Finding the perfect fit

    By Peter Jaret

    Peter Jaret is the author of several health-related books, including In Self-Defense: The Human Immune System, Nurse: A World of Care, and Impact: On the Frontlines of Public Health. A frequent contributor to National Geographic, The New York Times, Reader’s Digest, Health magazine, More, AARP Bulletin, and dozens of other periodicals, Jaret is the recipient of an American Medical Association award for journalism and two James Beard awards. He lives in Petaluma, California.

    1. [1] https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=281 (date accessed 07/26/2017)
    2. The statements by Siemens Healthineers customers described herein are based on results that were achieved in the customer’s unique setting. Since there is no “typical” hospital and many variables exist (e.g., hospital size, case mix, level of IT adoption) there can be no guarantee that other customers will achieve the same results.