{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:23:51Z","timestamp":1747185831797,"version":"3.40.5"},"reference-count":10,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,1,8]],"date-time":"2024-01-08T00:00:00Z","timestamp":1704672000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>This study was performed to explore the diagnostic value of cardiac computed tomography angiography (CCTA) for endothelial insufficiency (EIS) of a left atrial appendage (LAA) disc\u2010like occluder.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty\u2010nine patients with nonvalvular atrial fibrillation who underwent placement of an LAA disc\u2010like occluder (LAmbre; Lifetech Scientific) in our hospital were retrospectively analyzed. Patients who were found to have contrast agent entering the LAA at the 3\u2010month postoperative CCTA examination underwent Hounsfield unit (HU) measurement of the LAA and construction of a three\u2010dimensional\u00a0(3D) model of the device for preliminary discernment between peri\u2010device leakage (PDL) and EIS. These patients were then further examined by transesophageal echocardiography (TEE) to check for concordance with the computed tomography (CT) findings. According to the CT and TEE results, all patients were divided into the PDL group, total endothelialization group, and EIS group. The endothelial conditions and other implantation\u2010related results were also tracked at the 6\u2010month follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All 59 patients underwent successful implantation of the LAmbre LAA closure device with no severe adverse events during the procedure. Thirty\u2010five patients were found to have contrast agent entering the LAA at the 3\u2010month postoperative CCTA follow\u2010up. Based on the CT HU measurement and the 3D construction analysis results, these 35 patients were divided into the PDL group (19 patients) and the EIS group (16 patients). In the PDL group, the contrast agent infiltrated from the shoulder along the periphery of the occluder on two\u2010dimensional (2D)\u00a0CT images, and the 3D model showed a gap between the LAA and the device cover. However, the CCTA images of the other 16 patients in the EIS group showed that the contrast agent in the occluder on the 2D CTA images and 3D construction model confirmed the absence of a gap between the LAA and the device cover. TEE confirmed all of the CT results. The 6\u2010month follow\u2010up results showed that 14 of 19 patients in the EIS group achieved total endothelialization, whereas this number in the PDL group was only five of 19 patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>CCTA can replace TEE for examination of the endothelialization status, and patients with EIS have a higher chance of endothelialization than patients with PDL.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.16176","type":"journal-article","created":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T05:40:35Z","timestamp":1704778835000},"page":"389-398","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiac computed tomography angiography for assessment of endothelial insufficiency of left atrial appendage disc\u2010like occluder"],"prefix":"10.1111","volume":"35","author":[{"given":"Zhiyong","family":"Duan","sequence":"first","affiliation":[{"name":"Departments of Cardiology of Zhongshan Hospital Wusong Branch Fudan University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Genling","family":"Shi","sequence":"additional","affiliation":[{"name":"Departments of Cardiology of Zhongshan Hospital Wusong Branch Fudan University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Wang","sequence":"additional","affiliation":[{"name":"Departments of Radiology Zhongshan Hospital Wusong Branch Fudan University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongjian","family":"Shen","sequence":"additional","affiliation":[{"name":"Equipment Division of Zhongshan Hospital Wusong Branch Fudan University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengshi","family":"Xie","sequence":"additional","affiliation":[{"name":"Departments of Cardiology of Zhongshan Hospital Wusong Branch Fudan University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhenzhou","family":"Zhang","sequence":"additional","affiliation":[{"name":"Departments of Cardiology of Zhongshan Hospital Wusong Branch Fudan University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xixi","family":"Dai","sequence":"additional","affiliation":[{"name":"Departments of Cardiology of Zhongshan Hospital Wusong Branch Fudan University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weifeng","family":"Yao","sequence":"additional","affiliation":[{"name":"Departments of Cardiology of Zhongshan Hospital Wusong Branch Fudan University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunfei","family":"Liu","sequence":"additional","affiliation":[{"name":"Departments of Cardiology of Zhongshan Hospital Wusong Branch Fudan University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0967-4285","authenticated-orcid":false,"given":"Hongyu","family":"Shi","sequence":"additional","affiliation":[{"name":"Departments of Cardiology of Zhongshan Hospital Wusong Branch Fudan University Shanghai 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of Cardiovascular 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