Congenital Absence of the Left Atrial Appendage

Collier, Patrick; Cavalcante, João L.; Phelan, Dermot; Thavendiranathan, Paaladinesh; Dahiya, Arun; Grant, Andrew; Kwon, Deborah; Thamilarasan, Maran

doi:10.1161/circimaging.112.975516

Cited by 22 publications

(21 citation statements)

References 4 publications

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“…2 In fetal life, the LAA is a functional LA. [4][5][6] The shape and the size of the LAA vary significantly from patient to patient. [4][5][6] The shape and the size of the LAA vary significantly from patient to patient.…”

Section: Discussionmentioning

confidence: 99%

“…The LAA is located within the pericardium, 3 produces high levels of atrial natriuretic factor and contributes to the contractile functions of the LA. [4][5][6] The shape and the size of the LAA vary significantly from patient to patient. LAA often has multiple crenellations and lobes, which are potential sites for thrombus formation in the setting of atrial arrhythmias and blood stasis.…”

Section: Discussionmentioning

confidence: 99%

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Congenital Absence of the Left Atrial Appendage Visualized by 3D Echocardiography in Two Adult Patients

et al. 2015

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Congenital absence of left atrial appendage (LAA) is an extremely rare condition and its physiological consequences are unknown. We present two cases of incidental finding of a congenitally absent LAA in a 79-year-old male who presented for routine transesophageal echocardiogram (TEE) to rule out intracardiac thrombus prior to placement of biventricular implantable cardioverter-defibrillator and a 54-year old female who presented for TEE prior to radiofrequency ablation of atrial fibrillation. Characterization of patients with such an absence is important because congenitally absent LAA may be confused with flush thrombotic occlusion of the appendage. There are very few published reports of congenital absence of LAA. To our knowledge, our report is the first to demonstrate the congenital absence of LAA by 3D transesophageal echocardiography.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Congenital Absence of the Left Atrial Appendage Visualized by 3D Echocardiography in Two Adult Patients

et al. 2015

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“…In a CT study, Koplay et al showed that left atrial appendages can have various shapes resembling horseshoes, hand‐fingers, fans, wings, hooks, wedges, and swans (Koplay et al, ). Sometimes there is congenital agenesis of the left atrial appendage (Collier et al, ), which has been reported to vary markedly in macroscopic anatomy with sex and age (Veinot et al, ).…”

Section: Discussionmentioning

confidence: 99%

Anatomical features and clinical importance of left atrial diverticula

et al. 2013

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To assess the anatomical features and clinical importance of left atrial diverticula and atrial accessory appendages in patients undergoing cardiac computed tomography with multidetector computed tomography. A total of 1305 consecutive patients (385 female, 29.5%; 920 male, 70.5%) were assessed using electrocardiogram-gated computed tomography between May 2010 and June 2013. The anatomical features and the prevalences of left atrial diverticula and left atrial accessory appendages were retrospectively assessed by four radiologists. The relationships between the prevalence and size of the diverticula and the age and gender of the patients were assessed. Among the 1305 patients, 610 (46.7%) exhibited 708 left atrial diverticula, and 62 (4.8%) exhibited left atrial accessory appendages. The most common locations of the left atrial diverticula were the right anterior superior wall (n = 328, 46.3%) and the lateral superior wall (n = 96, 13.5%). In addition to classical cystic and tubular diverticula, 49 (3.7%) of the patients exhibited mixed (cystic-tubular), conical, or hook-shaped diverticula and diverticular forms containing mural calcifications. There was no significant relationship between the prevalence of diverticula and the age and gender of the patients (P > 0.05). In addition to tubular and cystic diverticula, the left atrial wall can host different diverticular forms (such as mixed, conical, calcific, and hook shaped). It could be beneficial to assess the left atrium using MDCT to determine the source of emboli in cryptogenic embolism and to reduce complications associated with interventional procedures performed for left atrial arrhythmias.

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“…Missing an LAA thrombus in an accessory lobe might be possible if one is not aware of this variation of the LAA. Collier et al (24) determined congenital absence of LAA in a 73-year-old woman with atrial fibrillation. This anomaly was not observed in present specimens.…”

Section: Laa Morphologymentioning

confidence: 99%

Human left atrial appendage anatomy and overview to its clinical significance

Üçerler

İkiz²,

Özgür³

2013

Anadolu Kardiyol Derg

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Objective: The left atrial appendage (LAA) is an important anatomic region since it is a source of thromboembolism in patients with atrial fibrillation. Although this anatomic and clinical relation it has received little attention until recent years. Methods: This descriptive laboratory study was performed in 56 hearts of adult formalin fixed cadavers. The morphological characteristics of LAA were recorded. The distances between the orifices of left superior pulmonary veins (LSPV), circumflex artery, left anterior descending (LAD) artery, mitral valve and LAA were also measured in this study. Results: The morphological appearance of the LAA was classified into two different ways. There were two types according to the first classification: slender like a crooked finger (in 73.2%) and stump-like (in 26.8%). The lobe number of LAA was two in 64.3% specimens and three in 35.7%. The types of LAA were Cactus (24%), Chicken Wing (12%), Windsock (38%) and Cauliflower (26%) according to the second classification. The LAA orifice was oval-shaped in 37.5% and round-shaped in 62.5%. The bridge on the orifice was determined in one specimen. The longest diameter of LAA orifice was 16.5±4 mm. The presence of accessory left atrial appendage was observed in one specimen. The distance between LAA orifice and oval fossa was 27.5±5.5 mm. Conclusion: We highlighted the anatomic features of LAA and LAA orifice. LAA diameters, shape and the relation between neighboring structures in relation to atrial fibrillation and surgical approaches were discussed. (Anadolu Kardiyol Derg 2013; 13: 566-72) Key words: Anatomy, atrial fibrillation, left atrial appendage, left atrium, thrombus Original Investigation Özgün Araşt›rma 566ÖZET Amaç: Sol aurikula atriyal fibrilasyonlu hastalarda tromboemboli nedeni olduğu için önemli bir anatomik bölgedir. Bu anatomik ve klinik ilişkiye rağmen son yıllara kadar az dikkate alınmıştır. Yöntemler: Bu tanımlayıcı laboratuvar çalışmasında 56 adet formalinle fikse edilmiş kalp üzerinde çalışıldı. Sol aurikulanın morfolojik özellikleri kaydedildi. Bu çalışmada üst pulmoner venler, sirkumfleks arter, sol ön inen arter ve mitral kapak ile sol aurikula açıklığı arası da ölçüldü. Bulgular: Sol aurikulanın morfolojik görünümü iki farklı şekilde sınıflandırıldı. İlk sınıflandırmaya göre iki tip mevcuttu: İnce çomak parmak şekilli (%73,2) ve kütük şekilli (%26,8). Sol aurikula lob sayısı ise olguların %64,3'ünde iki iken %35,7'sinde üç idi. İkinci sınıflandırmaya göre sol atriyal aurikula (SAA) tipleri, Kaktüs (%24), Tavuk Kanadı (%12), Rüzgar Hortumu (%38) ve Karnabahar (%26) şeklindeydi. Sol aurikula açıklığı %37,5 olguda oval şekilli iken %62,5 olguda yuvarlak şekilli idi. Sol aurikula açıklığının en uzun çapı 16,5±4,0 mm olarak bulundu. Aksesuvar sol aurikula bir olguda görüldü. Sol aurikula açıklığı ve fossa ovalis arası uzaklık ise 27,5±5,5 mm idi. Sonuç: Sol aurikula ve sol aurikula açıklığının anatomik özellikleri aydınlatıldı. Sol aurikula açıklığının çapı, şekli ve çevre yapılarla ilişkisinin, atrial ...

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Congenital Absence of the Left Atrial Appendage

Abstract: The online-only Data Supplement is available with this article at http://circimaging.ahajournals.org/lookup/suppl

Cited by 22 publications

References 4 publications

Congenital Absence of the Left Atrial Appendage Visualized by 3D Echocardiography in Two Adult Patients

Congenital Absence of the Left Atrial Appendage Visualized by 3D Echocardiography in Two Adult Patients

Anatomical features and clinical importance of left atrial diverticula

Human left atrial appendage anatomy and overview to its clinical significance

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