{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:43:58Z","timestamp":1792683838253,"version":"4.5.0"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,9,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Transesophageal echocardiogram is currently the standard preprocedural imaging for left atrial appendage occlusion. This study aimed to assess the additive value of preprocedural computed tomography (CT) planning versus stand\u2010alone transesophageal echocardiogram imaging guidance to left atrial appendage occlusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We retrospectively reviewed 485 Watchman implantations at a single center to compare the outcomes of using additional CT preprocedural planning (n=328, 67.6%) versus stand\u2010alone transesophageal echocardiogram guidance (n=157, 32.4%) for left atrial appendage occlusion. The primary end point was the rate of successful device implantation without major peri\u2010device leak (&gt;5\u00a0mm). Secondary end points included major adverse events, total procedural time, delivery sheath and devices used, risk of major peri\u2010device leak and device\u2010related thrombus at follow\u2010up imaging. A single\/anterior\u2010curve delivery sheath was used more commonly in those who underwent CT imaging (35.9% versus 18.8%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). Additional preprocedural CT planning was associated with a significantly higher successful device implantation rate (98.5% versus 94.9%;\n                      <jats:italic>P<\/jats:italic>\n                      =0.02), a shorter procedural time (median, 45.5\u00a0minutes versus 51.0\u00a0minutes;\n                      <jats:italic>P<\/jats:italic>\n                      =0.03) and a less frequent change of device size (5.6% versus 12.1%;\n                      <jats:italic>P<\/jats:italic>\n                      =0.01), particularly device upsize (4% versus 9.4%;\n                      <jats:italic>P<\/jats:italic>\n                      =0.02). However, there was no significant difference in the risk of major adverse events (2.1% versus 1.9%;\n                      <jats:italic>P<\/jats:italic>\n                      =0.87). Only 1 significant peri\u2010device leak (0.2%) and 5 device\u2010related thrombi were detected in follow\u2010up (1.2%) with no intergroup difference.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Additional preprocedural planning using CT in Watchman implantation was associated with a higher successful device implantation rate, a shorter total procedural time, and a less frequent change of device sizes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.120.020615","type":"journal-article","created":{"date-parts":[[2021,8,16]],"date-time":"2021-08-16T14:17:53Z","timestamp":1629123473000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["Additive Value of Preprocedural Computed Tomography Planning Versus Stand\u2010Alone Transesophageal Echocardiogram Guidance to Left Atrial Appendage Occlusion: Comparison of Real\u2010World Practice"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9158-714X","authenticated-orcid":false,"given":"Chak\u2010yu","family":"So","sequence":"first","affiliation":[{"name":"Division of Cardiology Henry Ford Health System Detroit MI"},{"name":"Division of Cardiology Department of Medicine and Therapeutics Prince of Wales HospitalChinese University of Hong Kong Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guson","family":"Kang","sequence":"additional","affiliation":[{"name":"Division of Cardiology Henry Ford Health System Detroit MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro A.","family":"Villablanca","sequence":"additional","affiliation":[{"name":"Division of Cardiology Henry Ford Health System Detroit MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9672-9255","authenticated-orcid":false,"given":"Abel","family":"Ignatius","sequence":"additional","affiliation":[{"name":"Division of Cardiology Henry Ford Health System Detroit MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2461-9740","authenticated-orcid":false,"given":"Saleha","family":"Asghar","sequence":"additional","affiliation":[{"name":"Division of Cardiology Henry Ford Health System Detroit MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3471-6889","authenticated-orcid":false,"given":"Dilshan","family":"Dhillon","sequence":"additional","affiliation":[{"name":"Division of Cardiology Henry Ford Health System Detroit MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4917-4012","authenticated-orcid":false,"given":"James C.","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology Henry Ford Health System Detroit MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arfaat","family":"Khan","sequence":"additional","affiliation":[{"name":"Division of Cardiology Henry Ford Health System Detroit MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3744-1806","authenticated-orcid":false,"given":"Gurjit","family":"Singh","sequence":"additional","affiliation":[{"name":"Division of Cardiology Henry Ford Health System Detroit MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiberio M.","family":"Frisoli","sequence":"additional","affiliation":[{"name":"Division of Cardiology Henry Ford Health System Detroit MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian P.","family":"O\u2019Neill","sequence":"additional","affiliation":[{"name":"Division of Cardiology Henry Ford Health System Detroit MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0334-6504","authenticated-orcid":false,"given":"Marvin H.","family":"Eng","sequence":"additional","affiliation":[{"name":"Division of Cardiology Henry Ford Health System Detroit MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5888-2673","authenticated-orcid":false,"given":"Thomas","family":"Song","sequence":"additional","affiliation":[{"name":"Division of Radiology Henry Ford Health System Detroit MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milan","family":"Pantelic","sequence":"additional","affiliation":[{"name":"Division of Radiology Henry Ford Health System Detroit MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William W.","family":"O\u2019Neill","sequence":"additional","affiliation":[{"name":"Division of Cardiology Henry Ford Health System Detroit MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5784-9924","authenticated-orcid":false,"given":"Dee Dee","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Cardiology Henry Ford Health System Detroit MI"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000000041"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2014.08.009"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.4330\/wjc.v7.i2.65"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.111.963892"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12909"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2016.07.038"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/openhrt-2017-000627"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.27514"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jew212"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2014.05.026"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.976449"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.114389"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.04.029"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.10.010"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.12.040"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.01.076"}],"container-title":["Journal of the American Heart 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