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Morphometrical features of left atrial appendage in the atrial fibrillation patients subjected to left atrial appendage closure
Affiliations- Heart Embryology and Anatomy Research Team (HEART), Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
- Department of Cardiovascular Surgery and Transplantology, Jagiellonian University Medical College, Krakow, Poland
- Division of Cardiovascular Sciences, The University of Manchester, United Kingdom
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Abstract
Background: This study aimed to evaluate the morphometrical features of left
atrial appendage (LAA) in patients with atrial fibrillation, subjected to LAA percutaneous
closure (LARIAT) for stroke prevention.
Materials and methods: Computed tomography (CT) scans of 51 patients with
atrial fibrillation subjected to LARIAT procedure were comparatively evaluated with
50 patients with sinus rhythm (control group). Three-dimensional reconstructions
were created using volume-rendering for evaluation.
Results: No differences were found in LAA types of distribution (cauliflower:
25.5 vs. 34.0%, chicken wing: 45.1 vs. 46.0%, arrowhead: 29.4 vs. 20.0%, all
p > 0.05) between groups. However, the study group was characterized by LAAs
with a lower number of lobes. The LAA orifice anteroposterior and transverse
diameters (19.3 ± 4.12 vs. 17.2 ± 4.0 mm, p = 0.01 and 25.1 ± 5.1 vs. 20.5 ±
± 4.4 mm, p = 0.001), orifice area (387.2 ± 133.9 vs. 327.1 ± 128.3 mm2,
p = 0.02) and orifice perimeter (70.2 ± 12.5 vs. 61.2 ± 11.6 mm, p = 0.04) was
significantly larger in atrial fibrillation patients. More oval LAA orifices was found
in atrial fibrillation group (94.0 vs. 70.4%, p = 0.001). No statistically significant
differences were found in LAA body length (47.4 ± 15.4 vs. 43.7 ± 10.9 mm,
p = 0.17), body width (24.7 ± 5.6 vs. 24.4 ± 5.8 mm, p = 0.81), and chamber
depth (17.7 ± 3.5 vs. 16.5 ± 3.8 mm, p = 0.11). Calculated LAA ejection fraction
was significantly lower in study group compared to healthy patients (16.4 ± 14.9
vs. 48.2 ± 12.9%, p = 0.001).
Conclusions: Important morphometrical differences in LAA orifice have been
found, which was significantly larger and more oval in patients with atrial fibrillation
compared to healthy controls. Although no difference in LAA body type
and size was observed; the LAA ejection fraction was significantly lower in atrial
fibrillation rhythm patients.
Abstract
Background: This study aimed to evaluate the morphometrical features of left
atrial appendage (LAA) in patients with atrial fibrillation, subjected to LAA percutaneous
closure (LARIAT) for stroke prevention.
Materials and methods: Computed tomography (CT) scans of 51 patients with
atrial fibrillation subjected to LARIAT procedure were comparatively evaluated with
50 patients with sinus rhythm (control group). Three-dimensional reconstructions
were created using volume-rendering for evaluation.
Results: No differences were found in LAA types of distribution (cauliflower:
25.5 vs. 34.0%, chicken wing: 45.1 vs. 46.0%, arrowhead: 29.4 vs. 20.0%, all
p > 0.05) between groups. However, the study group was characterized by LAAs
with a lower number of lobes. The LAA orifice anteroposterior and transverse
diameters (19.3 ± 4.12 vs. 17.2 ± 4.0 mm, p = 0.01 and 25.1 ± 5.1 vs. 20.5 ±
± 4.4 mm, p = 0.001), orifice area (387.2 ± 133.9 vs. 327.1 ± 128.3 mm2,
p = 0.02) and orifice perimeter (70.2 ± 12.5 vs. 61.2 ± 11.6 mm, p = 0.04) was
significantly larger in atrial fibrillation patients. More oval LAA orifices was found
in atrial fibrillation group (94.0 vs. 70.4%, p = 0.001). No statistically significant
differences were found in LAA body length (47.4 ± 15.4 vs. 43.7 ± 10.9 mm,
p = 0.17), body width (24.7 ± 5.6 vs. 24.4 ± 5.8 mm, p = 0.81), and chamber
depth (17.7 ± 3.5 vs. 16.5 ± 3.8 mm, p = 0.11). Calculated LAA ejection fraction
was significantly lower in study group compared to healthy patients (16.4 ± 14.9
vs. 48.2 ± 12.9%, p = 0.001).
Conclusions: Important morphometrical differences in LAA orifice have been
found, which was significantly larger and more oval in patients with atrial fibrillation
compared to healthy controls. Although no difference in LAA body type
and size was observed; the LAA ejection fraction was significantly lower in atrial
fibrillation rhythm patients.
Keywords
left atrial appendage closure, left atrial appendage shape, atrial fibrillation, stroke
About this articleTitle
Morphometrical features of left atrial appendage in the atrial fibrillation patients subjected to left atrial appendage closure
Journal
Issue
Article type
Original article
Pages
814-821
Published online
2022-08-25
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994
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614
DOI
Pubmed
Bibliographic record
Folia Morphol 2023;82(4):814-821.
Keywords
left atrial appendage closure
left atrial appendage shape
atrial fibrillation
stroke
Authors
K. M. Słodowska
J. Batko
J. P. Hołda
D. Dudkiewicz
M. Koziej
R. Litwinowicz
K. Bartuś
M. K. Hołda
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