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Folia Morphol (Warsz). 2019 Jun 4. doi: 10.5603/FM.a2019.0066. [Epub ahead of print]

Morphometric study of the left atrial appendage related to closure device deployment: A cadaveric study in Thai population.

Author information

1
Chulalongkorn University, Department of Anatomy, Faculty of Medicine, King Chulalongkorn Memorial Hospital, ChulalongkornUniversity, Bangkok 10330, Thailand, 10330 Bangkok, Thailand.
2
Department of Anatomy, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Rama 4 Road, 10330 Bangkok, Thailand. fmedvct@gmail.com.

Abstract

This study aims to investigate the left atrial appendage (LAA) regarding external morphology, positional relation of the ostium of LAA to the left superior pulmonary vein (LSPV), ostium shape, ostium diameter and functional depth. LAA of sixty-five cadaveric hearts were examined. The prevalence of Cauliflower, Windsock, Cactus and Chicken wing type of LAA were 27.7%, 27.7%, 26.1% and 18.5% respectively. LAA with two lobes was the most common. All specimens showed no accessory LAA. The relation of the ostium to the LSPV was found in two types which were mid-type (LAA ostium was at the same level as LSPV) in 29 cases (44.6%) and inferior type (LAA ostium was below the level of LSPV) in 36 cases (55.4%). The shapes of LAA ostium were oval and round with a prevalence of 55.4% and 44.6% respectively. The diameter of round type ranged from 9.53- 21.51 mm with a mean of 14.56±2.6 mm. While in oval type, the long and short diameters ranged from 11.61-31.71 mm with a mean of 14.23 ± 4.2 mm and 6.70- 23.90mm with a meanof 11.66 ± 3.5mm, respectively. The surface area of the ostiumwas calculated from the ostium diameter, range from 71.29-594.92 mm²with a mean of 169.56±84.73 mm². There was no statistically significant difference of the surface area between LAA types. The mean functional depth of LAA was 11.57±4.43 mm. The functional depth of the Windsock-type appeared to be statistically significant from the others. However, there was no correlation between the functionaldepth and the ostium surface area. This morphometric data might be beneficial for deployment of LAA closure device in the Thai population.

KEYWORDS:

functional depth of LAA; left atrial appendage; left atrial appendage closure; left superior pulmonary vein; ostium diameter; ostium shape; ostium surface area

PMID:
31162625
DOI:
10.5603/FM.a2019.0066
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