Cardiac CT Assessment of Left Atrial Accessory Appendages and Diverticula

Abbara, Suhny; Mundo-Sagardia, Jorge A.; Hoffmann, Udo; Cury, Ricardo C.

doi:10.2214/ajr.08.2229

Cited by 60 publications

(68 citation statements)

References 10 publications

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“…The prevalence of right anterosuperior location of LAD in our study in patients with and without AF was similar to previous studies 6,7 ; however, the prevalence of left lateral wall location of LAD in patients with AF in our series was much higher than that reported in our series and previous studies in patients without AF. 6,7 LAD in the right inferior wall or interatrial septum tended to be tubiform or irregular.…”

Section: Presence Locations and Morphology Of Ladsupporting

confidence: 90%

“…6,7 LAD in the right inferior wall or interatrial septum tended to be tubiform or irregular. Tubiform LAD usually had a long and tortuous body.…”

Section: Presence Locations and Morphology Of Ladmentioning

confidence: 94%

“…7 Because there is not an established definition, and some LAD are not like a cyst according to our experience and previous studies, 6,7 we used an adapted definition of LAD from a previous study. 7 We defined LAD as projecting from the heart cavity to outside the plane of the left atrial wall, irrespective of its etiology.…”

Section: Image Analysismentioning

confidence: 99%

“…5 Recent studies have shown that left atrial diverticula (LAD) are a common anatomic variant in patients referred for computed tomography (CT) coronary angiography. 6,7 Because LAD are possible sites for catheter entrapment, they theoretically could contribute to complications, such as perforation and thrombus formation in AF catheter ablation. However, the anatomic features of LAD are largely unknown in patients referred for catheter ablation for AF.…”

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confidence: 99%

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Left Atrial Diverticula in Patients Referred for Radiofrequency Ablation of Atrial Fibrillation

Peng

Yang

et al. 2012

Circ: Arrhythmia and Electrophysiology

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Background-The anatomic features of left atrial diverticula (LAD) are still unclear in patients with atrial fibrillation (AF).The purpose of this study was to evaluate the prevalence and morphological characteristics of LAD in patients referred for radiofrequency transcatheter ablation of AF with dual-source computed tomography. Methods and Results-Dual-source computed tomography images were obtained in 214 patients referred for AF catheter ablation and 214 sex-and age-matched control subjects.

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Section: Presence Locations and Morphology Of Ladsupporting

confidence: 90%

“…6,7 LAD in the right inferior wall or interatrial septum tended to be tubiform or irregular. Tubiform LAD usually had a long and tortuous body.…”

Section: Presence Locations and Morphology Of Ladmentioning

confidence: 94%

Section: Image Analysismentioning

confidence: 99%

mentioning

confidence: 99%

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Left Atrial Diverticula in Patients Referred for Radiofrequency Ablation of Atrial Fibrillation

Peng

Yang

et al. 2012

Circ: Arrhythmia and Electrophysiology

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“…The incidence of LA diverticulum/accessory appendage was found to be 10% to 23%. [2][3][4] This condition is thought to be associated with ectopic foci that initiate AF, incomplete ablation lines on the LA roof, and potential complications such as steam pop and cardiac tamponade during AF ablation. We report here the first case of a giant LA thrombus originating from LA diverticulum, without LA appendage thrombus formation, in a patient with AF.…”

mentioning

confidence: 99%

Large Thrombus Originating From Left Atrial Diverticulum

et al. 2011

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A 45-year-old man was admitted to our hospital for evaluation of a left atrial (LA) mass. The patient had a history of dilated hypertrophic cardiomyopathy, atrial fibrillation (AF), diabetes mellitus, and sustained ventricular tachycardia that was treated by implantation of a cardioverter-defibrillator. He had developed AF 1 year earlier and was followed up at the outpatient clinic. He had been treated with warfarin at a dose that resulted in an international normalized ratio of 2.0 to 3.0. The LA mass was detected incidentally on routine transthoracic echocardiography. He was referred to our hospital because the size of the LA mass was unchanged after intensive anticoagulation with intravenous heparin infusion. The mobile LA mass along the interatrial septum was detected by transthoracic echocardiography in the apical 4-chamber view (Figure 1 and Movie I in the online-only Data Supplement). Transesophageal echocardiography showed a huge mobile mass (2.6ϫ1.4 cm) originating from the roof of the LA (Figure 2A and Movie II in the online-only Data Supplement) with remarkable spontaneous echo contrast. No evidence of thrombus formation was found in the LA appendage ( Figure 2B). The mass had a stalk that came from the diverticulum on the LA roof based on

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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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Cardiac CT Assessment of Left Atrial Accessory Appendages and Diverticula

Abstract: Left atrial diverticula and accessory appendages are commonly found on cardiac-gated CT.

Cited by 60 publications

References 10 publications

Left Atrial Diverticula in Patients Referred for Radiofrequency Ablation of Atrial Fibrillation

Left Atrial Diverticula in Patients Referred for Radiofrequency Ablation of Atrial Fibrillation

Large Thrombus Originating From Left Atrial Diverticulum

Anatomical features and clinical importance of left atrial diverticula

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