Whereas the left atrial appendage plays a rather minor role under physiological circumstances, it gains an importance in patients with atrial fibrillation. Compelling evidence has revealed that the left atrial appendage is implicated as the source of thrombus in the vast majority of strokes in atrial fibrillation. Oral anticoagulation remains the standard of care for stroke prevention in atrial...

Myxoma is the most common benign tumor of the heart, but it is very rare for it to originate from the left atrial appendage. Distinguishing between a mass, a thrombus, and a tumor in the body of the left atrium with preoperative transthoracic or transesophageal echocardiography is very difficult, even more so in patients with mitral valve disease and chronic atrial fibrillation. A 50-year-old m...

METHODS A total of 34 patients undergoing open heart surgery were included. Atrial tissue was obtained from the right atrial free wall, right atrial appendage, left atrial free wall and left atrial appendage, respectively. The messenger ribonucleic acid (mRNA) amount of the genes was measured by reverse transcription–polymerase chain reaction and normalized to the mRNA levels of glyceraldehyde ...

OBJECTIVE To determine the relations between left atrial appendage function, spontaneous echo contrast, and thromboembolism in patients with different modes of permanent pacemakers. PATIENTS AND METHODS 88 patients with pacemaker implantation and 25 healthy controls in sinus rhythm had transoesophageal echocardiographic examination of the left atrial appendage. Left atrial size, appendage are...

OBJECTIVES This study examined the effect of endocardial and transthoracic direct current (DC) shocks on left atrial and left atrial appendage function in humans with structural heart disease. BACKGROUND DC cardioversion of atrial fibrillation (AF) to sinus rhythm is associated with transient left atrial and left atrial appendage dysfunction and the development of spontaneous echo contrast (S...

OBJECTIVE To assess the interobserver variability between two observers from different echocardiographic laboratories. DESIGN Two observers reviewed video recordings blinded to the other's diagnosis. In part I (n = 88), they determined interobserver variability for spontaneous echo contrast, left atrial thrombi, and appendage thrombi. No diagnostic criteria for thrombi were defined. In part I...

Objectives: To prevent death from atrial ®brillation, a cardiac disease which kills by producing emboli. Atrial ®brillation causes about 25% of strokes and increases stroke rate by ®ve times. Over 90% of these embolic strokes are from clots originating in the left atrial appendage. This study addresses the surgical feasibility of removing the appendage to prevent future deaths in two subcategor...

BACKGROUND Mean platelet volume has been associated with stroke in patients with atrial fibrillation. However, its role as a predictor of left atrial stasis, assessed by transesophageal echocardiography, in patients with non-valvular atrial fibrillation has not yet been clarified. METHODS Single center cross-sectional study comprising 427 patients admitted to the emergency department due to s...

AIM We validated transthoracic echocardiographic measurements of left atrial appendage flow velocity by comparing them with transoesophageal echocardiographic measurements. METHODS AND RESULTS Eighty-four consecutive patients (mean age, 64.6 years) with various cardiac diseases, who underwent both transthoracic echocardiography and transoesophageal echocardiography were studied. Thirty-two pa...

IN an exploration of the left atrium via an atrial septal defect during a recent cardiac catheterization in this laboratory, the catheter tip entered the left atrial appendage. An exaggerated "a" wave observed in the pressure contour from the left atrial appendage was striking and exceeded in amplitude the "a" wave from the left atrium proper. Following a similar observation shortly thereafter ...