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Endocardial occlusion of incompletely surgically ligated left atrial appendage using an Amplatzer septal occluder device
A 55-year-old man underwent a surgical Maze procedure for the treatment of nonvalvular atrial fibrillation with concomitant surgical suture ligation of left atrial appendage (LAA). Baseline transesophageal echocardiography (TEE) and computed tomography (CT) angiography revealed a normal LAA free of thrombus (A). Ten days after surgery, he developed an acute embolic stroke. Repeat TEE and CT angiography demonstrated an incompletely surgically ligated LAA (ISLL) without thrombus, with the ISLL neck dimensions measuring 3 × 3 mm (B). He was promptly initiated on oral anticoagulation (OAC) therapy. But owing to intolerance to...
Source: Heart Rhythm - June 24, 2013 Category: Cardiology Authors: Arash Aryana, Sean Bailey, Padraig Gearoid O’Neill, André d’Avila Tags: Image Source Type: research

Left atrial appendage and thromboembolism: Shape matters
The assessment of the left atrial appendage (LAA) morphology is a relatively new concept as the use of computed tomography (CT) and magnetic resonance imaging has become common in the preablation assessment of patients with atrial fibrillation (AF). In the not so distant past, transesophageal echocardiogram (TEE) was the primary modality used to analyze the LAA. Three-dimensional rendering of the LAA has allowed assessment and classification of different morphologies and now their correlation with thromboembolic risk. In this issue of HeartRhythm, Kimura et al make a case for a specific LAA morphology being related to a hi...
Source: Heart Rhythm - February 18, 2013 Category: Cardiology Authors: Sumit Verma Tags: Editorial Commentary Source Type: research