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Coronary angiographic finding of thrombus in the left atrial appendage
I Sakamoto1, K Hayashi, N Matsunaga
1Department of Radiology, Nagasaki University School of Medicine, Japan.
Insights
Coronary angiography can diagnose left atrial appendage (LAA) thrombus. The presence of coronary neovascularity and fistula suggests spontaneous thrombus resolution, potentially avoiding invasive procedures.
Area of Science:
- Cardiology
- Diagnostic Imaging
Background:
- Left atrial appendage (LAA) thrombus is a significant risk factor for stroke.
- Accurate diagnosis of LAA thrombus is crucial for appropriate management.
Purpose of the Study:
- To evaluate the diagnostic utility of coronary angiography for detecting left atrial appendage (LAA) thrombus.
- To investigate the association between coronary neovascularity, fistula formation, and LAA thrombus resolution.
Main Methods:
- Retrospective analysis of 34 patients with suspected LAA thrombus.
- Coronary angiography was performed to identify coronary neovascularity and fistula.
- Transthoracic echocardiography and open-heart surgery were used for confirmation and follow-up.
Main Results:
- Coronary angiography revealed coronary neovascularity and fistula in all 34 patients, suggesting LAA thrombus.
- Echocardiography detected LAA thrombus in only one patient.
- In 18 of 28 surgically treated patients, LAA thrombus had resolved.
Conclusions:
- Coronary angiography is a valuable tool for diagnosing LAA thrombus.
- Coronary neovascularity and fistula formation may predict spontaneous resolution of LAA thrombus.
Purpose:
The value of coronary angiography in the diagnosis of thrombus in the left atrial appendage (LAA) was retrospectively analyzed.
Material And Methods:
The study covers 34 patients in whom coronary angiography showed coronary neovascularity in LAA with coronary artery-left atrial fistula indicating LAA thrombus. All 34 patients underwent transthoracic echocardiography within one week of coronary angiography. Open-heart surgery was undertaken 2-31 months after angiography in 28 patients.
Results:
Coronary neovascularity and coronary artery-left atrial fistula arose from the left circumflex artery in 28 patients, and from the left circumflex artery and the right coronary artery in the remaining 6 patients. By echocardiography, LAA thrombus was detected in only one of the 34 patients. In 18 of the 28 patients who underwent open-heart surgery, LAA thrombus was found at surgery to have resolved.
Conclusion:
Coronary angiography is useful in the diagnosis of LAA thrombus, and coronary neovascularity and fistula formation may indicate that the thrombus can spontaneously resolve.