Left atrial appendage thrombus detection in routine workflow for patients with atrial fibrillation under oral anticoagulation: transoesophageal echocardiography vs. cardiac computed tomography

In 12% of OAC-treated patients, a thrombus was detected in at least one exam, with concordant TEE and CT diagnoses in only 25%. Both methods excluded thrombi in 80% of cases. LAA flow velocity correlated with TEE findings, whereas LA volume showed no association with CT. Discrepancies highlight diagnostic challenges: TEE is operator-dependent, and CT is limited by flow and timing.