Imaging Corner

Successful Left Atrial Appendage Closure (LAAC) Using 3D Transesophageal Echocardiogram (TEE)

Images courtesy UC Davis Medical Center, Sacramento, California.

Images courtesy UC Davis Medical Center, Sacramento, California.

This case of left atrial appendage closure (LAAC) demonstrates the advantages of 3D transesophageal echocardiography (TEE) over 2D imaging. An 81-year-old female with a past medical history of chronic atrial fibrillation (AF), hypertension, diabetes, distant stroke without residual deficit, and moderate aortic stenosis was referred for LAAC. She presented in chronic nonvalvular AF and with a recent lower gastrointestinal bleed. Due to her condition, the patient could not tolerate long-term anticoagulation and therefore underwent a Watchman (Boston Scientific) implant procedure. Precise measurement of the landing zone was performed using 4D TEE (on the Acuson SC2000 Prime ultrasound system [Siemens Healthineers]), and the Watchman device was implanted with no complications other than minimal interatrial septal defect. 

Reprinted with permission from EP Lab Digest Aug 2019;19(8). Copyright 2019 HMP Global.