Left atrial appendage


Left atrial appendage

Infobox Anatomy
Name = PAGENAME
Latin = auricula sinistra
GraySubject = 138
GrayPage = 533


Caption = Heart seen from above. (Left auricula labeled at bottom left.)


Caption2 = Section of the heart showing the ventricular septum. (Left auricula labeled at upper right.)
System =
Precursor =
MeshName =
MeshNumber =
DorlandsPre = a_73
DorlandsSuf = 12169673
The left atrial appendage (LAA) (left auricular appendix, left auricula, left auricle) cite journal |author=Akdeniz B, Badak O, Bariş N, "et al" |title=Left atrial appendage-flow velocity predicts cardioversion success in atrial fibrillation |journal=Tohoku J. Exp. Med. |volume=208 |issue=3 |pages=243–50 |year=2006 |month=March |pmid=16498232 |doi= |url=http://joi.jlc.jst.go.jp/JST.JSTAGE/tjem/208.243?from=PubMed] is a conical muscular pouch connected to the left atrium of the heart.

It has a distinct embryologic origin.cite journal |author=Donal E, Yamada H, Leclercq C, Herpin D |title=The left atrial appendage, a small, blind-ended structure: a review of its echocardiographic evaluation and its clinical role |journal=Chest |volume=128 |issue=3 |pages=1853–62 |year=2005 |month=September |pmid=16162795 |doi=10.1378/chest.128.3.1853 |url=http://www.chestjournal.org/cgi/pmidlookup?view=long&pmid=16162795]

Anatomy

It is somewhat constricted at its junction with the principal cavity; it is longer, narrower, and more curved than the right atrial appendage, and its margins are more deeply indented.

It is directed forward and toward the right and overlaps the root of the pulmonary artery.

Terminology

In older texts, the term "left auricle" was often used to describe the structure now known as the left atrium.

Clinical significance

In atrial fibrillation, thromboemboli are thought to arise from the left atrial appendage, which may lead to ischaemic damage to the brain, kidneys, or other organs supplied by the systemic circulation.cite journal |author=Parekh A, Jaladi R, Sharma S, Van Decker WA, Ezekowitz MD |title=Images in cardiovascular medicine. The case of a disappearing left atrial appendage thrombus: direct visualization of left atrial thrombus migration, captured by echocardiography, in a patient with atrial fibrillation, resulting in a stroke |journal=Circulation |volume=114 |issue=13 |pages=e513–4 |year=2006 |month=September |pmid=17000914 |doi=10.1161/CIRCULATIONAHA.106.617886 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=17000914] Elimination of the structure has been proposed.cite journal |author=Stöllberger C, Schneider B, Finsterer J |title=Elimination of the left atrial appendage to prevent stroke or embolism? Anatomic, physiologic, and pathophysiologic considerations |journal=Chest |volume=124 |issue=6 |pages=2356–62 |year=2003 |month=December |pmid=14665520 |doi= |url=http://www.chestjournal.org/cgi/pmidlookup?view=long&pmid=14665520]

It can serve as an approach for mitral valve surgery.cite journal |author=Guhathakurta S, Kurian VM, Manmohan, Cherian KM |title=Mitral valve reoperation through the left atrial appendage in a patient with mesocardia |journal=Tex Heart Inst J |volume=31 |issue=3 |pages=316–8 |year=2004 |pmid=15562857 |doi= |url=]

Function

Functions as a reservoir for the left atrium.

References


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