Morphologic Characteristics of the Left Atrial Appendage, Roof, and Septum: Implications for the Ablation of Atrial Fibrillation

Wongcharoen, Wanwarang; Tsao, Hsuan‐Ming; Wu, Mei-Han; Tai, Ching‐Tai; Chang, Shih‐Lin; Lin, Yenn‐Jiang; Liu, Shin-Huei; Chen, Yi Jen; Sheu, Ming-Huei; Chang, Cheng-Yen; Chen, Shih‐Ann

doi:10.1111/j.1540-8167.2006.00549.x

Cited by 106 publications

(64 citation statements)

References 31 publications

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“…All these variations also need to be considered to safely place the occlusion device. Wongcharoen et al (17) emphasized that LAA orifice and LSPV not at the same level had higher incidence in patients with atrial fibrillation.…”

Section: Laa Morphologymentioning

confidence: 99%

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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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Section: Laa Morphologymentioning

confidence: 99%

“…Wongcharoen et al (17) studied in 49 specimens on multidetector CT scan. They examined LAA orifice and LSPV at the same level in 64%, LAA orifice inferior to LSPV in 13% and LAA orifice superior to LSPV in 22% of specimens; consecutively 76.8%, 19.6% and 3.6% in present study.…”

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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“…The shape and distance of the roof and the pouch presence was observed as described in the study of Wongcharoen et al (4). The number of pulmonary vein openings into LA was recorded.…”

Section: Anatomic Measurementsmentioning

confidence: 99%

“…Beside this, left atrium (LA) roof and septum are also important regions to improve the success rate of treating AF patients with catheter ablation (4,5). An overview of LA and proximal parts of pulmonary veins anatomy can provide useful information for surgical approaches, catheter ablation and radiologic examinations (1,(4)(5)(6)(7). The purpose of this paper was also to provide an anatomical review about LA and proximal parts of pulmonary veins.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, the pulmonary veins and posterior atrial wall have become important targets of interventional therapies (1)(2)(3). Beside this, left atrium (LA) roof and septum are also important regions to improve the success rate of treating AF patients with catheter ablation (4,5). An overview of LA and proximal parts of pulmonary veins anatomy can provide useful information for surgical approaches, catheter ablation and radiologic examinations (1,(4)(5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

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Anatomic characteristics of left atrium and openings of pulmonary veins

İkiz¹,

Üçerler²,

Özgür³

2014

Anadolu Kardiyol Derg

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Objective: Left atrium (LA) and left atrial pulmonary venous anatomy have clinical importance for atrial fibrillation (AF) and cardiac tumor surgery. A detailed anatomic knowledge of these structures may faciliate clinical evaluations. The aim of this study was to assess LA size and to demonstrate other anatomic features of LA with pulmonary vein openings in normal population. Methods: This descriptive laboratory study was performed in 56 hearts of adult formalin fixed cadavers. The number of pulmonary vein openings into LA was recorded. Different patterns of pulmonary vein openings were described such as common ostium and additional vein. Results: The roof of LA was determined as flat (75%), convex (14.3%) or concave (10.7%) in specimens. A roof pouch was present in 8.9% of specimens. The diameter of LA roof, the anteroposterior LA diameter and the LA diameter between septum and lateral wall were recorded. Thin areas on the atrial wall were observed in front of a light source around left atrial appendage orifice. Septal band was found in 7.1% of specimens. Five different patterns of pulmonary vein openings were recorded: The common arrangement, the unilateral common ostium, the unilateral additional vein, the additional vein on both side and the complex type were observed respectively in 41 specimens (73.2%), 10 specimens (17.9%), three specimens (5.4%), one specimen (1.8%) and one specimen (1.8%). Conclusion: It is expected that the data from present study will be a guide to the clinicians during the surgical approaches or radiologic examinations of LA and pulmonary vein openings into LA. (Anadolu Kardiyol Derg 2014; 14: 674-8)

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Preprocedure preparation for catheter‐based ablation of atrial fibrillation

Huizar

Ellenbogen

2015

Practical Guide to Catheter Ablation of Atrial Fibrillation

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Morphologic Characteristics of the Left Atrial Appendage, Roof, and Septum: Implications for the Ablation of Atrial Fibrillation

Cited by 106 publications

References 31 publications

Human left atrial appendage anatomy and overview to its clinical significance

Human left atrial appendage anatomy and overview to its clinical significance

Anatomic characteristics of left atrium and openings of pulmonary veins

Preprocedure preparation for catheter‐based ablation of atrial fibrillation

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