The right atrial auricle-Worthy of a new look

The right atrium is the least well studied cardiac chamber. Even less is known about the right atrial appendage (RAA). Recently, the RAA has been shown to be the site of numerous and diverse pathological processes. Furthermore, the RAA can also be the site of origin of atrial fibrillation with obvious implications for ablation procedures. No standard method of transthoracic echocardiography (TTE) for imaging of the RAA can be found in current literature, despite numerous reports for transesophageal echocardiography (TEE).

The purpose of this study was to determine if a reliable transthoracic window could be found for consistent and reliable imaging of the RAA.

30 patients (15 men and 15 women) were included into this study. All patients were placed in the left lateral decubitus position and echocardiography was performed with a Vivid E9 ultrasound system (GE Healthcare). The RAA was visualized by tilting the probe infero-medially from the standard apical four chamber view.

The RAA was visualized in all 30 patients. The RAA followed a consistent upwards and leftwards path anterior to the aortic root.

TTE is a valid method of imaging of the RAA.