Chicken wing left atrial appendage morphology was associated with a significantly lower rate of LAA clot and atrial fibrillation compared to non-chicken wing morphology (p=0.0177).
Observational (n=135)
Is left atrial appendage morphology associated with the incidence of atrial fibrillation and LAA clot in patients with valvular heart lesions?
Non-chicken wing LAA morphologies, particularly windsock, are significantly associated with a higher risk of LAA clot and atrial fibrillation in patients with valvular heart disease.
p-value: p=0.0177
Aim To associate the morphology and characteristics, namely, flow velocity, external orifice diameter (EOD), and contractility of the left atrial appendage with the incidence of atrial fibrillation (AF) and left atrial appendage (LAA) clot using transesophageal echocardiogram (TEE) and intraoperative findings during valve surgery. Materials and methods An observational study of a total of 81 patients during the course of this study with an inclusion criterion of them being in AF and/or having a LAA clot, while 54 patients in the control group being the ones in a sinus rhythm and without a LAA clot. Results Out of the 81 study patients, 60 patients with AF had a LAA clot, while 21 patients were in AF without a LAA clot. The commonest occurrence of LAA morphology was found to be the chicken wing type (37%). Chicken wing morphology, when compared to non-chicken wing morphology, showed a significantly lower rate of LAA clot and AF (p = 0.0177). Within the 60 patients with LAA clot, windsock (50%) was the commonest morphology. Conclusion In this comprehensive study, we have found a significant statistical association between the morphology and characteristics of LAA with that of LAA clot and AF. This, therefore, broadens the horizons of application of these findings to patients who are in normal sinus rhythm (NSR) without a clot. Given the marked risk associated with non-chicken wing LAA morphologies, especially the windsock, cactus, and cauliflower types, clinicians should maintain heightened vigilance in patients exhibiting these anatomical patterns, particularly when LAA flow velocity or contractility falls below 25 cm/s and the EOD exceeds 25 mm. Such a combination identifies individuals at distinctly increased risk for future LAA thrombus development and AF, warranting proactive monitoring and potential early intervention.
Jagtap et al. (Fri,) conducted a observational in Valvular heart lesions with atrial fibrillation or left atrial appendage clot (n=135). Chicken wing left atrial appendage morphology vs. Non-chicken wing morphology was evaluated on Incidence of left atrial appendage clot and atrial fibrillation (p=0.0177). Chicken wing left atrial appendage morphology was associated with a significantly lower rate of LAA clot and atrial fibrillation compared to non-chicken wing morphology (p=0.0177).