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European Journal of Medical Research

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Open Access 01-12-2023 | Stroke | Research

Impact of left atrial appendage morphology on thrombus formation in TAVI patients with atrial fibrillation

Authors: N. Abanador-Kamper, J. Bepperling, M. Seyfarth, P. Haage, L. Kamper

Published in: European Journal of Medical Research | Issue 1/2023

Abstract

Purpose

We aimed to correlate left atrial appendage (LAA) morphology with thrombus formation in patients with severe aortic valve stenosis and atrial fibrillation.

Methods

We analyzed LAA morphology and the prevalence of a thrombus in 231 patients with atrial fibrillation and severe aortic valve stenosis that were referred for pre-interventional CT scan before trans-catheter aortic valve implantation (TAVI) between 2016 and 2018. In addition, we documented neuro-embolic events depending on the presence of LAA thrombus within a follow-up of 18 months.

Results

The overall distribution of different LAA morphologies was chicken-wing 25.5%, windsock 51.5%, cactus 15.6% and cauliflower 7.4%. Compared to chicken-wing morphology, patients with non-chicken-wing morphology showed a significantly higher thrombus rate (OR: 2.48, 95%; CI 1.05 to 5.86, p = 0.043). Within the 50 patients with a LAA thrombus, we observed chicken-wing (14.0%), windsock (62.0%), cactus (16.0%) and cauliflower (8.0%) configuration. In patients with LAA thrombus those with chicken-wing configuration have a higher risk (42.9%) to develop neuro-embolic events compared to non-chicken-wing configuration (20.9%).

Conclusion

We found a lower LAA thrombus rate in patients with chicken-wing morphology compared to patients with non-chicken-wing configuration. However, in the presence of thrombus, those patients with chicken-wing morphology showed a doubled risk for neuro-embolic events compared to patients with non-chicken-wing morphology.

These results must be confirmed in larger trials but underline the importance of LAA evaluation in thoracic CT scans and could have an impact on the anticoagulation management.

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Title: Impact of left atrial appendage morphology on thrombus formation in TAVI patients with atrial fibrillation
Authors: N. Abanador-Kamper
J. Bepperling
M. Seyfarth
P. Haage
L. Kamper
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Stroke
Transcatheter Aortic Valve Implantation
Aortic Valve Stenosis
Atrial Fibrillation
Published in: European Journal of Medical Research / Issue 1/2023
Electronic ISSN: 2047-783X
DOI: https://doi.org/10.1186/s40001-023-01057-y

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Impact of left atrial appendage morphology on thrombus formation in TAVI patients with atrial fibrillation

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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