The Relationship Between Left Atrial Appendage Morphology and Thrombus presence in Patients with Atrial Fibrillation, Evaluated by Transesophageal Echocardiography

Document Type : Original Article

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Department of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Abstract

Background: Atrial fibrillation [AF] significantly increases the risk of thrombus formation in the left atrial appendage [LAA]. The morphology of the LAA has been suggested to play a crucial role in thrombus presence, yet its relationship remains unclear. Transesophageal echocardiography [TEE] is instrumental in evaluating LAA characteristics.
The aim of the work: This study aims to investigate the relationship between the morphology of the left atrial appendage and the presence of thrombus in patients with atrial fibrillation, utilizing transesophageal echocardiography for detailed assessment.
Patients and Methods: Fifty people with a documented medical necessity for Echocardiography due to atrial fibrillation were enrolled. LAA morphology was classified into different types [commonly categorized as Cactus, Chicken Wing, and Bowtie] based on echocardiographic findings. The presence of thrombus was assessed by TEE findings. Statistical analyses were performed to evaluate the association between LAA morphology and thrombus formation.
Results: Average age was 57.5 ± 11.2 [with a range of 41 to 80 years old]. Each person had at least one established cardiovascular disease risk factor. we discovered a strong correlation between the cauliflower shape of LAA and the formation of thrombi. Statistical analysis revealed a negative correlation among LAA empty velocity and thrombus formation.
Conclusion:  We concluded that RT3DTEE is technically feasible, provides accurate results, and additional diagnostic capability in the differential diagnosis of certain cases involving suspected LAA thrombi. More thorough researches are needed to confirm our findings. 

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