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Casts of the left atrial appendage, obtained at postmortem examination, show its variable and complex morphology. One left atrial appendage contained a thrombus (first from the left, upper row). Ante mortem, two patients had atrial fibrillation (first and second from the left, upper row); the remaining five patients had sinus rhythm. Haemodynamic changes in atrial fibrillation may lead to enlargement of the left atrial appendage. A patent foramen ovale was found in one patient (first from the right, lower row). The smaller volume of the left atrial appendage might be a consequence of a left-to-right shunt.