Review Articles
Echocardiographic assessment of the left atrial appendage

https://doi.org/10.1016/S0735-1097(99)00472-6Get rights and content
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Abstract

The left atrial (LA) appendage is a common source of cardiac thrombus formation associated with systemic embolism. Transesophageal echocardiography allows a detailed evaluation of the structure and function of the appendage by two-dimensional imaging and Doppler interrogation of appendage flow. Specific flow patterns, reflecting appendage function, have been characterized for normal sinus rhythm and various abnormal cardiac rhythms. Appendage dysfunction has been associated with LA appendage spontaneous echocardiographic contrast, thrombus formation and thromboembolism. These associations have been studied extensively in patients with atrial fibrillation or atrial flutter, in patients undergoing cardioversion of atrial arrhythmias and in patients with mitral valve disease. The present review summarizes the literature on the echocardiographic assessment of LA appendage structure, function and dysfunction, which has become an integral part of the routine clinical transesophageal echocardiographic examination.

Abbreviations

AF
atrial fibrillation
AFL
atrial flutter
LA
left atrium (-ial)
LAA
left atrial appendage
LV
left ventricle (-icular)
SEC
spontaneous echocardiographic contrast
SPAF
Stroke Prevention in Atrial Fibrillation
TEE
transesophageal echocardiography

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