Atrial thrombi detection prior to XXXX : Diagnostic accuracy of cardiac computer tomography versus transesophageal echocardiography.

@entity1 @entity715 @entity358 @entity2286
BACKGROUND: @entity1 routinely undergo TEE prior to @entity358 ( @entity358 ) in order to rule out the presence of intra-atrial thrombi. CCT is also routinely conducted prior to the procedure to determine cardiac anatomy. Although it has been demonstrated that CCT can also rule out intra-atrial thrombi, the use of CCT for thrombi detection is controversial. The primary objective was to determine the utility of cardiac computed tomography (CCT) for detection of atrial thrombi as compared to transesophageal echocardiography (TEE). METHODS: @entity1 who underwent @entity358 between 2010-2011 with CTs and TEEs completed within 3 days of each other were retrospectively identified. TEE reports were analyzed, while CCTs were interpreted by a cardiologist specializing in CCTs. Severe spontaneous echo contrast or @entity715 detected on TEE were considered positive, as were filling defects found on CCT. RESULTS: A total of 51 @entity1 undergoing @entity358 (mean age 59.4    9.5 years; 75% male; ejection fraction 60    12%) had both TEE and CCT in timely fashion. By TEE, 0 left atrial appendage (LAA) thrombi were identified with mild to moderate spontaneous echo contrast in 4 @entity1 . By CCT, 2 definite LAA thrombi were identified and thrombi in 4 @entity1 could not be ruled out. Specificity, positive predictive value ( @entity2286 ), and negative predictive value (NPV) for CCT were 88%, 0%, and 100%, respectively. CONCLUSIONS: CCT is an effective tool in ruling out atrial thrombi prior to @entity358 . TEE should be completed only if CCT is positive.
