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The left atrial appendage is a pouch-like structure located in the upper part of the left atrium. [1] Left atrial appendage occlusion (LAAO) is an alternative therapy to oral anticoagulation in a certain subset of patients with atrial fibrillation.
The left atrial appendage can serve as an approach for mitral valve surgery. [16] The body of the left atrial appendage is anterior to the left atrium and parallel to the left pulmonary veins. The left pulmonary artery passes posterosuperiorly and is separated from the atrial appendage by the transverse sinus. [17]
Left atrial enlargement can be mild, moderate or severe depending on the extent of the underlying condition. Although other factors may contribute, left atrium size has been found to be a predictor of mortality due to both cardiovascular issues as well as all-cause mortality.
These clots develop in a small pouch called the left atrial appendage (LAA). If a clot dislodges and travels to the brain, it can cause a stroke.
The left heart has two chambers: the left atrium and the left ventricle, separated by the mitral valve. [8] The left atrium receives oxygenated blood back from the lungs via one of the four pulmonary veins. The left atrium has an outpouching called the left atrial appendage. Like the right atrium, the left atrium is lined by pectinate muscles. [25]
A common example that demonstrates this is the visibility of the left atrial appendage. This structure is known to form clots in atrial fibrillation and the LAA is rarely seen on TTE but readily seen on TEE. Cardioversion of atrial fibrillation in someone not on anticoagulation would require TEE to best visualize the LAA to rule out a thrombus.
Energy is delivered and the atrial tissue heated and destroyed in a series of steps as the microwave antenna is withdrawn behind the heart. The lesions form a "box-like" pattern around all four pulmonary veins behind the heart. The left atrial appendage is usually removed. [7] [8]
Not only the pulmonary vein, but the left atrial appendage can be a source of atrial fibrillation and is also ablated for that reason. [17] As atrial fibrillation becomes more persistent, the junction between the pulmonary veins and the left atrium becomes less of an initiator and the left atrium becomes an independent source of arrhythmias. [18]