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Left atrial appendage
Gray494.png
Heart seen from above. (Left auricula labeled at bottom left.)
Gray498.png
Section of the heart showing the ventricular septum. (Left auricula labeled at upper right.)
Latin auricula sinistra
Gray's subject #138 533

The left atrial appendage (LAA)[1] (left auricular appendix,[2] auricula,[2] left auricle[3]) is a muscular pouch connected to the left atrium of the heart.

It has a distinct embryologic origin.[4]

Contents

Terminology [edit]

Although the LAA is sometimes called the left auricle,[5] in older texts the term "left auricle" was often used differently to describe the structure now known as the left atrium.

Function [edit]

The LAA is a small pouch located high in the left atrium; it is within the pericardium and has a wall adjacent to the left ventricle. It appears to "function as a decompression chamber during left ventricular systole and during other periods when left atrial pressure is high".[6]

Clinical significance [edit]

In patients with atrial fibrillation, mitral valve disease, and other conditions, blood clots have a tendency to form in the LAA.[6] In atrial fibrillation, clots arise from the LAA in more than 90% of cases.[7] They may dislodge (forming emboli), which may lead to ischemic damage to the brain, kidneys, or other organs supplied by the systemic circulation.[8] Left atrial appendage occlusion is an experimental treatment to prevent stroke in atrial fibrillation.[9]

It can serve as an approach for mitral valve surgery.[10]

Function [edit]

Functions as a reservoir for the left atrium.

Radiology [edit]

The left atrial appendage can be seen on a standard posteroanterior x-ray, where the lower level of the left hilum becomes concave.[11]

Additional images [edit]

References [edit]

  1. ^ Akdeniz B, Badak O, Bariş N, et al. (March 2006). "Left atrial appendage-flow velocity predicts cardioversion success in atrial fibrillation" (– Scholar search). Tohoku J. Exp. Med. 208 (3): 243–50. doi:10.1620/tjem.208.243. PMID 16498232. [dead link]
  2. ^ a b "Gray's Anatomy". Retrieved 2008-12-14. 
  3. ^ Netter, Frank H. (1989). "Section III: Thorax". Atlas of Human Anatomy (2nd ed.). East Hanover, NJ: Novartis. ISBN 978-0-914168-81-2. 
  4. ^ Donal E, Yamada H, Leclercq C, Herpin D (September 2005). "The left atrial appendage, a small, blind-ended structure: a review of its echocardiographic evaluation and its clinical role". Chest 128 (3): 1853–62. doi:10.1378/chest.128.3.1853. PMID 16162795. 
  5. ^ Drake, Richard et al. (2010). Gray's Anatomy for Students. Churchill Livingstone. ISBN 978-0-443-06952-9. 
  6. ^ a b Al-Saady NM et al (1999) Left atrial appendage: structure, function, and role in thromboembolism: Review Heart 82:547-554
  7. ^ Blackshear JL, Odell JA (February 1996). "Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation". Ann. Thorac. Surg. 61 (2): 755–9. doi:10.1016/0003-4975(95)00887-X. PMID 8572814. 
  8. ^ Parekh A, Jaladi R, Sharma S, Van Decker WA, Ezekowitz MD (September 2006). "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". Circulation 114 (13): e513–4. doi:10.1161/CIRCULATIONAHA.106.617886. PMID 17000914. 
  9. ^ Stöllberger C, Schneider B, Finsterer J (December 2003). "Elimination of the left atrial appendage to prevent stroke or embolism? Anatomic, physiologic, and pathophysiologic considerations". Chest 124 (6): 2356–62. doi:10.1378/chest.124.6.2356. PMID 14665520. 
  10. ^ Guhathakurta S, Kurian VM, Manmohan, Cherian KM (2004). "Mitral valve reoperation through the left atrial appendage in a patient with mesocardia". Tex Heart Inst J 31 (3): 316–8. PMC 521780. PMID 15562857. 
  11. ^ Chest X-Ray Made Easy. Churchill Livingstone. 2002. ISBN 0-443-07008-3.  Text " Corne et al." ignored (help)

This article incorporates text from a public domain edition of Gray's Anatomy.



Original courtesy of Wikipedia: http://en.wikipedia.org/wiki/Left_atrial_appendage — Please support Wikipedia.
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135 news items

 
Healio
Fri, 26 Apr 2013 07:28:43 -0700

Patients with nonvalvular atrial fibrillation at risk for stroke who received left atrial appendage closure with the Watchman device experienced favorable changes in QOL at 12 months compared with patients treated with warfarin, according to an ...
 
Haaretz
Tue, 07 May 2013 03:30:52 -0700

Researchers from Hadassah University Hospital, Ein Karem had been conducting a study on sheep in which they implanted a stent from the heart's left ventricle to the left atrial appendage when, "suddenly, tissue was seen growing inside the stent." ...
 
MarketWatch (press release)
Fri, 17 May 2013 00:07:16 -0700

Thursday, May 23 Boston Scientific Symposium Featuring Left Atrial Appendage Closure For Stroke Prevention Boston Scientific is scheduled to host a symposium titled, "Left atrial appendage closure for stroke prevention: What every interventional ...
 
TheHeart.Org
Fri, 10 May 2013 07:14:50 -0700

Denver, CO - A long-term follow-up analysis of the PROTECT-AF trial shows—in contrast to shorter-term analyses based on the trial—that left atrial appendage (LAA) closure with the Watchman (Boston Scientific) is superior to warfarin with respect to ...

NewsNet5.com

NewsNet5.com
Thu, 16 May 2013 16:53:51 -0700

The Lariat procedure involves a system of catheters and wires that work together to deliver a suture to the left atrial appendage, closing it off so that blood cannot enter and clots cannot form. According to Dr. Ohad Ziv, more than 2 million Americans ...
 
PR Newswire (press release)
Tue, 21 May 2013 05:02:32 -0700

When implanted, TigerPaw II safely and effectively occludes the left atrial appendage (LAA) and conforms to its shape and thickness, minimizing the risk of tissue damage and accidental bleeding associated with other common closing methods used during ...

TCTMD

TCTMD
Tue, 14 May 2013 14:25:21 -0700

For patients with nonvalvular atrial fibrillation (A-fib), closing the left atrial appendage (LAA) with the Watchman device is superior to warfarin alone with regard to avoiding stroke and mortality, according to 4-year results of the PROTECT AF trial ...
 
Your Houston News
Thu, 09 May 2013 14:57:50 -0700

Patients who have atrial fibrillation (irregular heartbeat) are at particular risk for developing clots in the left atrial appendage (LAA) at the top of the left chamber of the heart. The clots can break off, travel within the body and cause a stroke ...
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