Left atrial appendage occlusion (LAAO) is rapidly growing as valid stroke prevention therapy in atrial fibrillation. Cardiac imaging plays an instrumental role in preprocedural planning, procedural execution, and postprocedural follow-up. Recently, cardiac computed tomography (CCT) has made significant advancements, resulting in increasing use both preprocedurally and in outpatient follow-up. It provides a noninvasive, high-resolution alternative to the current standard, transesophageal echocardiography, and may display advantages in both the detection and characterization of device-specific complications, such as peridevice leak and device-related thrombosis. The implementation of CCT in the follow-up after LAAO has identified new findings such as hypoattenuated thickening on the atrial device surface and left atrial appendage contrast patency, which are not readily assessable on transesophageal echocardiography. Currently, there is a lack of standardization for acquisition and interpretation of images and consensus on definitions of essential findings on CCT in the postprocedural phase. This paper intends to provide a practical and standardized approach to both acquisition and interpretation of CCT after LAAO based on a comprehensive review of the literature and expert consensus among European and North American interventional and imaging specialists.

中文翻译：

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左心耳封堵后心脏计算机断层扫描的立场声明


左心耳封堵术 （LAAO） 作为心房颤动的有效中风预防疗法正在迅速发展。心脏影像学检查在术前规划、手术执行和术后随访中起着重要作用。最近，心脏计算机断层扫描 （CCT） 取得了重大进展，导致术前和门诊随访的使用增加。它为当前标准经食管超声心动图提供了一种无创、高分辨率的替代方案，并且在检测和表征设备特异性并发症（例如设备周围渗漏和设备相关血栓形成）方面可能显示出优势。在 LAAO 后的随访中实施 CCT 发现了新的发现，例如心房装置表面的低衰减增厚和左心耳造影剂通畅，这些在经食管超声心动图上不容易评估。目前，缺乏图像采集和解释的标准化，也缺乏对术后阶段 CCT 基本发现定义的共识。本文旨在基于对文献的全面回顾和欧洲和北美介入和影像学专家的专家共识，为 LAAO 后 CCT 的获取和解释提供一种实用且标准化的方法。