Morphological and functional assessment of the left atrial appendage in daily practice: a comprehensive approach using basic and advanced echocardiography with practical tips.
Ashraf M AnwarPublished in: Journal of cardiovascular imaging (2024)
Cardioembolic stroke is the most serious and life-threatening complication of atrial fibrillation (AF), with an associated mortality up to 30% at 12 months. Approximately 47% of thrombi in valvular AF and 91% of thrombi in nonvalvular AF are localized in the left atrial appendage (LAA). Therefore, identification or exclusion of LAA thrombi is critical in many clinical situations. It is essential to assess LAA morphology and function using imaging modalities (particularly echocardiography) before, during, and after interventional procedures such as AF ablation and LAA occlusion. This review article describes the anatomical, physiological, and pathological background of the LAA, followed by an assessment of different echocardiographic modalities. Many practical points are included to improve the diagnostic accuracy and to minimize errors during image acquisition and interpretation. In each clinical scenario where LAA is the crucial target, specific and essential information and parameters are collected.
Keyphrases
- atrial fibrillation
- left atrial appendage
- catheter ablation
- left atrial
- oral anticoagulants
- direct oral anticoagulants
- left ventricular
- pulmonary hypertension
- heart failure
- computed tomography
- percutaneous coronary intervention
- primary care
- healthcare
- high resolution
- physical activity
- cardiovascular events
- risk factors
- deep learning
- adverse drug
- venous thromboembolism
- social media
- coronary artery disease
- bioinformatics analysis
- photodynamic therapy