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Morphology of the left atrial appendage
G Ernst1, C Stöllberger, F Abzieher
12nd Medical Department, KA Rudolfstiftung, Vienna, Austria.
The Anatomical Record
|August 1, 1995
Summary
The left atrial appendage (LAA) varies greatly in shape and volume. Larger LAA volumes are associated with atrial fibrillation, left ventricular hypertrophy, myocardial scars, and thrombi, impacting diagnosis.
Area of Science:
- Cardiology
- Anatomy
- Pathology
Background:
- The left atrial appendage (LAA) exhibits significant variations in size and shape.
- These morphological differences are observable via transesophageal echocardiography.
- Understanding LAA morphology is crucial for identifying pathological cardiac conditions.
Purpose of the Study:
- To investigate the morphology of the left atrial appendage.
- To explore associations between LAA morphology and pathological cardiac findings.
Main Methods:
- Post-mortem casting of 220 left atrial appendages using synthetic resin.
- Analysis of cast morphology, including principal axis course, ramifications, orifice diameters, outline, and volume.
- Correlation of cast morphology with clinical and autopsy data, including ECG findings.
Main Results:
- LAA volume ranged from 770-19,270 mm³ (mean 5,220 mm³).
- Increased LAA volume was significantly associated with atrial fibrillation, left ventricular hypertrophy, myocardial scars, closed foramen ovale, and LAA thrombi.
- The principal axis course was most frequently angulated below 100 degrees (42%), with over five ramifications in 56% of casts.
Conclusions:
- Left atrial appendages demonstrate substantial variability in volume and shape.
- This anatomical variability is critical for accurate interpretation of LAA imaging.
- Consideration of LAA morphology is particularly important for diagnosing thrombi.