When would you consider obtaining a cardiac CT in lieu of standard TEE for the detection of a left atrial appendage thrombus in atrial fibrillation?  

TEE is still the gold standard for the evaluation of left atrial appendage thrombus. That being said, there is certainly a role for cardiac CT as well, especially in patients with esophageal pathology or other conditions that increase the risk or contraindicate the use of TEE such as significant thr...

TEE offers a higher sensitivity than CT in detection of LAA thrombus and is often the preferred modality in these cases. However if the patient has a absolute or relative contraindications to TEE (recent or active GIB, esophageal issues, cervical spine issues, etc), increased risks of undergoing sed...