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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Cardiac CT assessment of left atrial accessory appendages and diverticula
Suhny Abbara1, Jorge A Mundo-Sagardia, Udo Hoffmann
1Department of Radiology, Section of Cardiovascular Imaging, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St. (GRB-290), Boston, MA 02114-2696, USA. sabbara@partners.org
Insights
Left atrial diverticula and accessory appendages are common findings on cardiac-gated CT scans. This study details their prevalence, morphology, size, and location in patients undergoing coronary artery evaluation.
Area of Science:
- Cardiovascular Imaging
- Anatomical Variations
- Radiology
Background:
- Left atrial abnormalities, such as diverticula and accessory appendages, can be incidentally discovered during cardiac imaging.
- Understanding their prevalence and characteristics is important for accurate interpretation of cardiac CT scans.
Purpose of the Study:
- To determine the prevalence, morphology, size, and location of left atrial diverticula and accessory appendages.
- To describe these findings in consecutive patients undergoing cardiac-gated CT for coronary artery evaluation.
Main Methods:
- Retrospective analysis of 529 consecutive patients who underwent contrast-enhanced 64-MDCT angiography.
- CT data sets were evaluated using multiplanar reconstructions, MIPs, and volume rendering.
- Presence, type, and location of left atrial appendages and diverticula were recorded.
Main Results:
- Left atrial diverticula were found in 20% of patients (104 diverticula in 101 patients).
- Left atrial accessory appendages were found in 8% of patients (44 appendages in 41 patients).
- Diverticula were predominantly superior and anterior; accessory appendages showed varied locations.
Conclusions:
- Left atrial diverticula and accessory appendages are common findings on cardiac-gated CT.
- These anatomical variations should be recognized during coronary artery evaluation CT scans.
Objective:
The purpose of this study is to describe the prevalence, morphology, size, and location of left atrial abnormalities including diverticula and accessory appendages in consecutive patients undergoing cardiac-gated CT for coronary artery evaluation.
Materials And Methods:
Routine retrospectively gated contrast-enhanced 64-MDCT angiography (0.75-mm collimation, 330-milliseconds gantry rotation time) was performed in 529 consecutive patients. CT data sets were evaluated using axial, sagittal, coronal, and interactive multiplanar reconstructions; maximum intensity projections (MIPs); and interactive volume rendering. The presence, type, and location of left atrial appendages and diverticula were recorded.
Results:
One hundred twenty-one patients had left atrial accessory appendages (n = 20) or left atrial diverticula (n = 81) or both (n = 20). One hundred four left atrial diverticula were found in 101 of the 529 patients (20%) and 44 accessory appendages in 41 patients (8%). Of the atrial diverticula, 88% were superior and anterior, 9% were right lateral superior, and 3% were inferior. Of accessory appendages, 34% were inferior posterior, 32% were left inferior, 18% were superior anterior, 14% were inferior posterior, and 2% were right inferior posterior. The average sizes of diverticula were 6.4 +/- 2.5 x 6.2 +/- 2.4 mm, and accessory appendages were 4.9 +/- 2.1 x 3.9 +/- 2.4 mm.
Conclusion:
Left atrial diverticula and accessory appendages are commonly found on cardiac-gated CT.
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