Imaging Corner

Successful LAAC Using 3D TEE

Images courtesy UC Davis Medical Center, Sacramento, California

This case involving a left atrial appendage closure (LAAC) demonstrates the advantages of 3D transesophageal echocardiography (TEE) over 2D imaging. An 81-year-old female with a past medical history of chronic atrial fibrillation (AF), hypertension, diabetes, distant stroke without residual deficit, and moderate aortic stenosis was referred for LAAC. She presented in chronic nonvalvular AF and with a recent lower gastrointestinal bleed. Due to her condition, the patient could not tolerate long-term anticoagulation, and therefore, underwent a WATCHMAN implant procedure (Boston Scientific). Precise measurement of the landing zone was performed using 4D TEE (on the ACUSON SC2000 PRIME ultrasound system from Siemens Healthineers), and the WATCHMAN device was implanted with no complications other than minimal interatrial septal defect. 

This case was submitted by Siemens Healthineers.