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Usefulness of Transesophageal Echocardiography for the Detection of Left Atrial Thrombi in Patients with Rheumatic Heart Disease
Author(s) -
LIN SHOALIN,
HSU TSUILEIH,
LIOU JERYOUNG,
CHEN CHENHUAN,
CHANG MAUSONG,
CHIANG HUNGTING,
CHEN CHUNGYIN
Publication year - 1992
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/j.1540-8175.1992.tb00454.x
Subject(s) - medicine , cardiology , atrial fibrillation , thrombus , appendage , p wave , heart disease , anatomy
Transesophageal (TEE) and transthoracic (TTE) echocardiograms were performed in 110 patients with rheumatic heart disease to evaluate the usefulness of these methods for the detection of left atrial thrombi. TEE was better than TTE for detecting left atrial thrombi (21 vs 9). The thrombi not detected by TTE were in the left atrial appendage in ten and over the left atrial posterior wall in two. Patients with left atrial thrombi had significantly smaller mitral valve area (P < 0.01) and greater left atrial dimension (P < 0.05) than those without. All patients with left atrial thrombi had atrial fibrillation. Thirty‐one patients underwent surgical intervention and 13 were found to have left atrial thrombi. TEE detected left atrial thrombi in all 13 patients with a sensitivity of 100%, specificity of 100%, and accuracy of 100%, while TTE detected left atrial thrombi in only nine of these 13 patients with a sensitivity of 69.2%, specificity of 100%, and accuracy of 87.1%. Thus, TEE is superior to TTE for the detection of left atrial thrombi, especially for those thrombi located in the left atrial appendage and along the left atrial posterior wall.