The following is a summary of “Pattern of Endothelialization in Left Atrial Appendage Occluder by Optic Coherence Tomography: A Pilot Study,” published in the December 2023 issue of Cardiology by Chen et al.
In this study, researchers explored the use of coronary optic coherence tomography (OCT) to visualize the endothelialization of left atrial appendage occluders (LAAO), a crucial aspect for preventing device-related thrombus.
The research involved 14 patients who had undergone pulmonary vein isolation and had a preexisting LAAO implanted for over a year. Utilizing OCT via a steerable sheath and coronary guiding catheter, the OCT probe location was adjusted, and a contrast medium was injected to visualize the LAAO surface. In vitro testing provided insights into the bare occluder’s surface characteristics. The OCT images revealed distinct patterns for different LAAO types, such as interrupted granules for the bare device and smooth, noninterrupted granules for the endothelialized Watchman surface.
The Amulet occluder displayed thin or thick endothelialization layers covering struts. The study demonstrated the feasibility of using OCT to achieve high-resolution visualization of LAAO endothelialization. Further investigations are warranted to determine antithrombotic regimens in cases of incomplete endothelialization, and the development of a dedicated OCT catheter for LAAO is proposed for enhanced precision in future studies.
Source: ahajournals.org/doi/10.1161/JAHA.123.030080
