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Related Experiment Videos

Left atrial appendage Doppler flow patterns: implications on thrombus formation.

M A García-Fernández1, E G Torrecilla, D San Román

  • 1Cardiology Department, Hospital General Gregorio Marañón, Madrid, Spain.

American Heart Journal
|October 1, 1992
PubMed
Summary

Transesophageal echocardiography identified three distinct left atrial appendage (LAA) flow patterns. Atrial fibrillation is linked to larger LAA size and increased thrombus risk, particularly with type III flow.

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Area of Science:

  • Cardiology
  • Medical Imaging

Background:

  • The clinical significance of left atrial appendage (LAA) flow dynamics remains incompletely understood.
  • Transesophageal echocardiography (TEE) is crucial for evaluating cardiac structures and function.

Purpose of the Study:

  • To analyze the characteristics and clinical implications of LAA flow patterns using TEE color Doppler.
  • To correlate LAA flow patterns with echocardiographic variables and cardiac rhythm.

Main Methods:

  • A TEE color Doppler study was performed on 39 consecutive patients.
  • LAA pulsed Doppler flow patterns were assessed and categorized.
  • Echocardiographic variables, cardiac rhythm, LAA size, spontaneous contrast, and thrombus presence were evaluated.

Main Results:

Related Experiment Videos

  • Three distinct LAA flow patterns were identified: Type I (biphasic, sinus rhythm, no thrombus/contrast), Type II (sawtooth, atrial fibrillation, dilated LAA, no thrombus/contrast), and Type III (no waves, atrial fibrillation, very dilated LAA, spontaneous contrast, high thrombus incidence).
  • Type I flow showed mean peak velocities of 28 cm/sec (filling) and 31 cm/sec (emptying).
  • Type II flow (atrial fibrillation) had a mean peak velocity of 49 cm/sec in a LAA area of 421 mm².
  • Type III flow (atrial fibrillation) was associated with significantly larger LAA area (619 mm²) and spontaneous contrast, with 6/7 patients having thrombus.

Conclusions:

  • TEE can differentiate three LAA flow patterns with distinct clinical implications.
  • Atrial fibrillation is associated with altered LAA flow (Types II and III) and larger LAA dimensions.
  • Type III LAA flow pattern in AF patients indicates a significantly higher risk of LAA thrombus formation.