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[Characterization of Doppler flow of the left atrial appendage and its relation to thrombi. A transesophageal
M A García Fernandez1, J E Azevedo, M M Moreno
1Instituto de Cardiologia, Madrid.
Insights
Transesophageal Doppler study identified three Left Atrial Appendage (LAA) flow patterns. Type III low flow in atrial fibrillation patients is strongly associated with LAA thrombus formation, highlighting Doppler
Area of Science:
- Cardiovascular Imaging
- Echocardiography
- Thrombosis Research
Background:
- Left Atrial Appendage (LAA) flow characteristics and their role in thrombus formation require further elucidation.
- Understanding LAA flow dynamics is crucial for assessing thromboembolic risk, particularly in patients with arrhythmias.
Purpose of the Study:
- To evaluate the significance of rhythm and Doppler parameters in predicting Left Atrial Appendage (LAA) thrombus formation.
- To analyze the clinical implications of LAA flow patterns using transesophageal pulsed Doppler.
Main Methods:
- Prospective transesophageal echocardiographic study involving 44 consecutive patients.
- Assessment of atrial fibrillation, LAA thrombi presence, and LAA Doppler flow patterns (peak velocity, wave area).
- Categorization of LAA Doppler flow into three types based on waveform characteristics.
Main Results:
- Type I biphasic flow (sinus rhythm) was not associated with LAA thrombus.
- Type II saw-fish flow (atrial fibrillation) was not associated with LAA thrombus.
- Type III low flow pattern (atrial fibrillation) was associated with the majority of LAA thrombi identified.
Conclusions:
- LAA Doppler flow patterns are important indicators for assessing LAA thrombus formation.
- Transesophageal echocardiography, utilizing Doppler parameters, aids in the risk stratification for thromboembolic events.
Objective:
The characteristics and clinical implications associated with Left Atrial Appendage (LAA) flow have not been clearly analyzed. The purpose of this transesophageal pulsed doppler study was to evaluate the importance of rhythm and echo doppler parameters on LAA thrombus formation.
Design:
Prospective study.
Setting:
Patients in a follow-up transesophageal echocardiographic study at Gregorio Maranon General Hospital, Madrid.
Patients:
Through a transesophageal echocardiographic color Doppler prospective study we evaluated 44 consecutive patients.
Interventions:
In each patient we measured presence of atrial fibrillation, presence of LAA thrombi and LAA doppler flow pattern parameters (peak velocity and area enclosed by the pulsed doppler filling and emptying waves).
Measurements:
We identified three types of LAA doppler flow: Type I, clearly defining biphasic flow, was present only in sinus rhythm patients and not associated to LAA thrombus; Type II saw-fish active flow pattern was detected only in atrial fibrillation patients not associated also with LAA thrombus. Type III low flow pattern occurred only in atrial fibrillation patients and is associated to the majority of LAA thrombus.
Conclusions:
These findings document the importance of LAA doppler factors when transesophageal echocardiography is used to study LAA thrombus formation.