Morphometrical features of left atrial appendage in the atrial fibrillation patients subjected to left atrial appendage closure

• Published in: Folia morphologica 2023-01, Vol.82 (4), p.814-821
• Main Authors: Słodowska, K. M., Batko, J., Hołda, J. P., Dudkiewicz, D., Koziej, M., Litwinowicz, R., Bartuś, K., Hołda, M. K.
• Format: Article
• Language: English
• Subjects: Body length; Body size; Cardiac arrhythmia; Computed tomography; Ejection fraction; Fibrillation; Statistical analysis; Stroke
• ISSN: 0015-5659; 1644-3284
• DOI: 10.5603/FM.a2022.0080

BACKGROUND: This study aimed to evaluate the morphometrical features of leftatrial appendage (LAA) in patients with atrial fibrillation, subjected to LAA percutaneousclosure (LARIAT) for stroke prevention. MATERIALS AND METHODS: Computed tomography (CT) scans of 51 patients withatrial fibrillation subjected to LARIAT procedure were comparatively evaluated with50 patients with sinus rhythm (control group). Three-dimensional reconstructionswere created using volume-rendering for evaluation. RESULTS: No differences were found in LAA types of distribution (cauliflower:25.5 vs. 34.0%, chicken wing: 45.1 vs. 46.0%, arrowhead: 29.4 vs. 20.0%, allp > 0.05) between groups. However, the study group was characterized by LAAswith a lower number of lobes. The LAA orifice anteroposterior and transversediameters (19.3 ± 4.12 vs. 17.2 ± 4.0 mm, p = 0.01 and 25.1 ± 5.1 vs. 20.5 ±± 4.4 mm, p = 0.001), orifice area (387.2 ± 133.9 vs. 327.1 ± 128.3 mm2,p = 0.02) and orifice perimeter (70.2 ± 12.5 vs. 61.2 ± 11.6 mm, p = 0.04) wassignificantly larger in atrial fibrillation patients. More oval LAA orifices was foundin atrial fibrillation group (94.0 vs. 70.4%, p = 0.001). No statistically significantdifferences were found in LAA body length (47.4 ± 15.4 vs. 43.7 ± 10.9 mm,p = 0.17), body width (24.7 ± 5.6 vs. 24.4 ± 5.8 mm, p = 0.81), and chamberdepth (17.7 ± 3.5 vs. 16.5 ± 3.8 mm, p = 0.11). Calculated LAA ejection fractionwas significantly lower in study group compared to healthy patients (16.4 ± 14.9vs. 48.2 ± 12.9%, p = 0.001). CONCLUSIONS: Important morphometrical differences in LAA orifice have beenfound, which was significantly larger and more oval in patients with atrial fibrillationcompared to healthy controls. Although no difference in LAA body typeand size was observed; the LAA ejection fraction was significantly lower in atrialfibrillation rhythm patients.