| Left atrial appendage | |
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| Heart seen from above. (Left auricula labeled at bottom left.) | |
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| 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 |
Anatomy
The LAA is a windsock-like structure that is long, tubular and hooked. Extending outward from it are lobes which are also described as branches with numerous "twigs". Its volume can vary among people from 1 to 19 cm3.[5][6]
The LAA is somewhat constricted at its junction with the principal cavity; it is longer, narrower, and more curved than the right atrial appendage, and its margins are more deeply indented. It is directed forward and toward the right and overlaps the root of the pulmonary artery.
Terminology
Although the LAA has sometimes been called the left auricle, in older texts the term "left auricle" was often used differently to describe the structure now known as the left atrium.
Clinical significance
In atrial fibrillation, blood clots arise from the left atrial appendage 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.[6]
It can serve as an approach for mitral valve surgery.[9]
Function
Functions as a reservoir for the left atrium.
Additional images
 Heart left atrial appendage tee view |
References
- ^ Akdeniz B, Badak O, Bariş N, et al. (March 2006). "Left atrial appendage-flow velocity predicts cardioversion success in atrial fibrillation" ([dead link] – Scholar search). Tohoku J. Exp. Med. 208 (3): 243–50. doi:. PMID 16498232. http://joi.jlc.jst.go.jp/JST.JSTAGE/tjem/208.243?from=PubMed.
- ^ a b "Gray's Anatomy". http://www.bartleby.com/107/pages/page533.html. Retrieved on 2008-12-14.
- ^ Netter, Frank H. (1989). "Section III: Thorax". Atlas of Human Anatomy (2nd ed.). East Hanover, NJ: Novartis. ISBN 978-0914168812.
- ^ 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:. PMID 16162795. http://www.chestjournal.org/cgi/pmidlookup?view=long&pmid=16162795.
- ^ Veinot, John P.; Phillip J. Harrity, Federico Gentile, et al. (1997). "Anatomy of the normal left atrial appendage: a quantitative study of age-related changes in 500 autopsy hearts: implications for echocardiographic examination". Circulation 96 (9): 3112–5. PMID 9386182. PMID 9386182. http://circ.ahajournals.org/cgi/content/full/96/9/3112.
- ^ a b 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:. PMID 14665520. http://www.chestjournal.org/cgi/pmidlookup?view=long&pmid=14665520.
- ^ 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:. PMID 8572814.
- ^ 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:. PMID 17000914. http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=17000914.
- ^ 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. PMID 15562857.
This article was originally based on an entry from a public domain edition of Gray's Anatomy. As such, some of the information contained herein may be outdated.
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