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Review
. 2022 Jun;33(2):195-202.
doi: 10.1007/s00399-022-00866-8. Epub 2022 May 23.

Anatomy of the left atrial appendage for the interventional cardiologist

David Gonzalez-Casal  1 , Tomás Datino  1 , Nina Soto  1 , Jorge González-Panizo  1 , Damián Sánchez-Quintana  2 , Yolanda Macias  3 , José-Ángel Cabrera  4   5
Affiliations
Review

Anatomy of the left atrial appendage for the interventional cardiologist

David Gonzalez-Casal et al. Herzschrittmacherther Elektrophysiol. 2022 Jun.

Abstract
in English, German

Exact knowledge of the anatomy of the left atrial appendage (LAA) is crucial for LAA isolation by catheter ablation and for interventional LAA occlusion in patients with atrial fibrillation. This review outlines the current anatomical understanding of LAA morphology from ostium to distal lobes, myocardial fiber orientation and wall structure, and adjacent structures such as the left upper pulmonary vein with the Coumadin ridge, the circumflex artery with its side branches, the aortic root, pulmonary artery, and the pericardial space. Insight into these details will facilitate these interventions and reduce the risk of complications.

Exakte Kenntnisse der Anatomie des linken Vorhofohrs („left atrial appendage“ [LAA]) sind entscheidend bei der LAA-Isolation durch Katheterablation und beim interventionellen LAA-Verschluss bei Patienten mit Vorhofflimmern. Diese Übersicht fast das aktuelle Verständnis der LAA-Anatomie zusammen: die LAA-Morphologie vom Ostium bis zu den distalen Lobi, die myokardiale Faserorientierung und Wandstruktur sowie die topographische Anatomie benachbarter Strukturen wie der linken oberen Pulmonalvene mit der „Coumadin ridge“, des Ramus circumflexus mit seinen Seitenästen, der Aortenwurzel, der Pulmonalarterie und der perikardialen Räume. Das Wissen um diese Details erleichtert die genannten Interventionen und reduziert das Komplikationsrisiko.

Keywords: Coumadin ridge; Left atrial appendage lobes; Left atrial appendage ostium; Left atrioventricular groove; Pectinate muscles; Phrenic nerve.

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References

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