Arrhythmias & electrophysiology

Cardiac CT Versus Transesophageal Echocardiography Following Left Atrial Appendage Closure: A Systematic Review and Meta-Analysis

Circ Cardiovasc ImagingPublished Systematic Review and Meta-Analysis

Pooled result · Residual leak (left atrial appendage patency)Result — go to the resultOdds ratio 2.26 95% CI 1.48–3.44

Authors' conclusion

Following LAAC, CCTA had higher odds of detecting residual leak and any PDL compared with TEE, whereas there were no significant differences in the detection of large PDL (> 5mm) and DRT between the 2 modalities. The findings of this meta-analysis should provide reassurance to patients and clinicians who prefer CCTA over TEE after LAAC. While DRT and left atrial appendage patency with visible PDL are known to be associated with thromboembolism, the clinical significance of left atrial appendage patency without visible PDL is uncertain and warrants further investigation.

Study context

Population
Patients who underwent both cardiac computed tomography angiography (CCTA) and transesophageal echocardiography (TEE) after percutaneous left atrial appendage closure (LAAC)
Participants
1,313 patients17 cohort studies
Comparison
Diagnostic utility of cardiac computed tomography angiography (CCTA) compared with TEE for post-LAAC device surveillance
Outcome
Residual leak (left atrial appendage patency)

Pooled result

As reported in the abstract

Odds ratio

2.26

95% CI 1.48–3.44

P = 0.0002

By group

CCTAvs TEE
odds ratio 2.26 (95% CI 1.48–3.44); P = 0.0002

Further pooled results

OutcomeCCTATEEOdds ratio (95% CI)P value
Any PDLI 2 =73%; 12 studies, 870 patients; moderate certainty51.6%35.5%1.59 (1.01–2.51)P = 0.04
Large PDL (>5 mm)I 2 =0%; 5 studies, 338 patients; moderate certainty2.8%0.8%3.12 (0.73–13.36)P = 0.13
DRTI 2 =0%; 6 studies, 584 patients; high-certainty1.7%1.7%1.0 (0.41–2.42)P = 1.0
Device-related thrombus (DRT) — Incidence of DRT
1.7%

Original publication

Cardiac CT Versus Transesophageal Echocardiography Following Left Atrial Appendage Closure: A Systematic Review and Meta-Analysis. Circ Cardiovasc Imaging. Published 27 June 2025. doi:10.1161/circimaging.125.018151

Composed by AI from the published abstract and checked against it. How Briefs are made →

Get them every week

New studies on this topic in My Week and in your Monday e-mail.

We e-mail you a sign-in link and a code. No password, no spam.