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We report the case of a patient with atrial fibrillation on standard electrocardiogram who underwent transesophageal echocardiography to rule out presence of thrombi in heart cavities. Pulsed-wave Doppler investigation revealed multiphasic waves consistent with atrial fibrillation in the left atrial appendage, while in the right atrial appendage, a biphasic flow was registered after QRS depolarization. Some hypotheses are made about the origin of this signal.

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Surgical ligation of the left atrial appendage is often performed during heart surgery for various diseases like mitral prosthesis implantation, mitral valve repair, and even coronary artery revascularization, mainly to prevent thrombus formation and systemic embolism in patients with atrial fibrillation. However surgical ligation is sometimes incomplete, thereby exposing the patient to residual embolic risk. We report two cases of surgical ligation of the left atrial appendage focusing on the transesophageal echographic aspects of complete or incomplete closure of the appendage.

No abstract