1. Thickness of the left atrial wall surrounding the left atrial appendage orifice
- Author
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Filip Bolechała, Jakub Hołda, Katarzyna Słodowska, Mateusz Koziej, Mateusz K. Hołda, Karolina Malinowska, Damian Dudkiewicz, and Paweł Kopacz
- Subjects
Appendage ,business.industry ,medicine.medical_treatment ,Tissue thickness ,Atrial fibrillation ,Anatomy ,medicine.disease ,Ablation ,Left atrial appendage occlusion ,Left atrial wall ,Left atrial ,Physiology (medical) ,Atrial Fibrillation ,medicine ,Humans ,Atrial Appendage ,Autopsy ,Heart Atria ,Cardiology and Cardiovascular Medicine ,business ,Body orifice ,Endocardium - Abstract
Introduction The aim of this study was to investigate the thickness of the left atrial wall surrounding the LAA orifice. Methods and results The tissue thickness around the LAA orifice was measured at four points (superior, inferior, anterior, and posterior) in 200 randomly selected autopsied human hearts. The thickest tissue was observed at the anterior point (3.17±1.41mm), followed by the superior (2.47±1.00mm), inferior (2.22±0.80mm) and posterior (2.22±0.83mm). The chicken wing LAA type was associated with the lowest thickness at the superior point compared to the cauliflower and arrowhead shapes (p=0.024). In hearts with an oval LAA orifice, the atrial wall was significantly thicker in all points than in specimens with a round LAA orifice (p > 0.05). Both the LAA orifice anteroposterior diameter and orifice surface area were negatively correlated with the tissue thickness in the anterior (r =-0.22, p=0.004 and r=-0.23, p=0.001) and posterior points (r=-0.24, p=0.001 and r=-0.28, p=0.005). Endocardial surface roughness was commonly in the inferior pole of the LAA orifice (75.5% of cases), while they are much less prevalent in other sectors around the orifice (anterior: 17.5%), superior: 4.0%, and posterior: 1.5%). Conclusions Although a significant heterogeneity in the atrial wall thickness around the LAA orifice was observed, the thickness in the respective points is quite conservative and depends only on LAA orifice size and shape, as well as LAA body shape. Thin atrial wall and endocardial surface roughness might challenge invasive procedures within this region. This article is protected by copyright. All rights reserved.
- Published
- 2021
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