Residual Leaks: Post LAAO Imaging - 2024 Quality Summit Presentation (Non-CE)-Residual Leaks: Post LAAO Imaging

Video Transcription

Video Summary

In this presentation, Dr. Homsey from Ohio State University discusses the complexities and challenges associated with residual leaks following left atrial appendage occlusion (LAAO) imaging. The session covers various imaging modalities available post-procedure, including transesophageal echocardiography (TE) and cardiac CT or MRI. Dr. Homsey explains that while any residual leak larger than five millimeters might be significant, guidelines and studies have shown varying figures regarding what constitutes an impactful leak. <br /><br />The discussion highlights the importance of imaging to assess leak size and location and explores the differences in sensitivity between TE and CT. CT is noted for its non-invasive nature and high sensitivity, though it's posed with concerns about contrast use and kidney impact. Dr. Homsey suggests that any leak can predict stroke, thus underlining the importance of accurate imaging and appropriate management.<br /><br />Additionally, the presentation reviews data from numerous studies that assess peri-device leaks, including their prevalence and significance post-LAAO. Techniques to address leaks, such as using occlusion devices, coiling, or radiofrequency ablation, are also discussed. Dr. Homsey emphasizes understanding the exact nature of leaks to tailor appropriate interventions. <br /><br />Finally, the session covers current and future studies, including a multi-center trial comparing TE and CT to ascertain superior methodologies for post-procedural imaging and leak management. Dr. Homsey advocates for personalized strategies depending on specific medical profiles and imaging results, suggesting that CT could potentially become the standard due to its effectiveness.

Keywords

residual leaks

left atrial appendage occlusion

imaging modalities

transesophageal echocardiography

cardiac CT

stroke prediction

peri-device leaks

occlusion devices

multi-center trial

personalized strategies