Архив номеров журнала "Кардиология"

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Журнал "Кардиология" №5, 2007

Выявление тромба ушка левого предсердия у больных с мерцательной аритмией и факторами риска развития тромбоэмболических осложнений: роль чреспищеводной эхокардиографии и мультиспиральной компьютерной томографии

Detection of Left Atrial Auricular Thrombus in Patients With Atrial Fibrillation and Risk Factors of Thromboembolic Complications: The Role of Transesophageal Echocardiography and Multispiral Computer Tomography

Transesophageal echocardiography (TEE) is routinely used for visualization of left auricular thrombi in patients with atrial fibrillation (AF). Multispiral computed tomography (MSCT) with the use of contrast preparations is a novel method of visualization of intracardiac structures. Forty three patients (27 men, 16 women aged 46–81 years) with duration of atrial fibrillation >48 hours and scheduled for sinus rhytm restoration were included in this study. TEE and MSCT were carried out in all patients during first 3 days of hospitalization. If according to both methods there were no thrombi in the left auricle cardioversion was performed. If data of one of the methods were suspicious of left auricular thrombus cardioversion was not performed. In these patients both investigations were repeated after 8 weeks of therapy with warfarin. If initially detected mass decreased or disappeared at the background of indirect anticoagulants, it was considered to be a thrombus. In 1/3 of patients repeat examination allowed to reject initial diagnosis of left auricular thrombosis. Simultaneous application of TEE and MSCT detected more thrombi than the use of either of these methods. Rate of detection of thrombi in left atrial auricle with the use of both methods was 32%.

Keywords: atrial fibrillation; left atrial auricular; transesophageal echocardiography; multispiral computed tomography.

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