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Structural Comparison between the Right and Left Atrial Appendages Using Multidetector Computed Tomography

View Article: PubMed Central - PubMed

ABSTRACT

The three-dimensional (3D) structures of the right atrial appendage (RAA) and left atrial appendage (LAA) were compared to clarify why thrombus formation less frequently occurs in RAA than in LAA. Morphological differences between RAA and LAA of 34 formalin-preserved cadaver hearts were investigated. Molds of RAA and LAA specimens were made and the neck areas, volumes of the atrial appendages (AA), and amount of pectinate muscles (PMs) were analyzed using multidetector computed tomography. In RAA, most PMs were connected to one another and formed a “dendritic” appearance and the inner surface area was smaller than in LAA. RAA had smaller volumes and larger neck areas than LAA. The ratios of the neck area/volume were larger and the amounts of PMs were smaller in RAA than in LAA. The volumes, neck areas, and amount of PMs of RAA were significantly correlated with those of LAA. According to the 3D structure, RAA appears to be suited for a more favorable blood flow, which may explain why the thrombus formation is less common in RAA than in LAA. Examining not only LAA but also RAA by transesophageal echocardiography may be useful in high-risk patients of thrombus formation in LAA because the volume, neck area, and amount of PMs of LAA reflect the shape of RAA.

No MeSH data available.


Related in: MedlinePlus

Quantification of the pectinate muscles (PMs) portion of the atrial appendages (AA) by three-dimensional morphological operation. (a) Determination of the PMs portion of the AA by computer analysis (short axis image). (b and c) The PMs were separated from the main body of AA (long axis image). (b) Main body, (c) PMs.
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fig2: Quantification of the pectinate muscles (PMs) portion of the atrial appendages (AA) by three-dimensional morphological operation. (a) Determination of the PMs portion of the AA by computer analysis (short axis image). (b and c) The PMs were separated from the main body of AA (long axis image). (b) Main body, (c) PMs.

Mentions: For each mold, the volumes, neck areas, and surface areas of AAs were measured. After binary-coded processing was performed for all volume data in the MDCT image, we performed 3D labeling processing and decided a domain of the whole AA. Computer analysis of overall volume from the number of voxel and neck and surface areas from the number of pixels was performed. From these measurements, the neck area/volume ratio and surface area/volume ratio for each AA were calculated. Furthermore, we excised PMs from each AA by 3D morphological operations (Figure 2) [19] and quantified differences between RAA and LAA. The amount of PMs was determined from the number of voxels using computer analysis.


Structural Comparison between the Right and Left Atrial Appendages Using Multidetector Computed Tomography
Quantification of the pectinate muscles (PMs) portion of the atrial appendages (AA) by three-dimensional morphological operation. (a) Determination of the PMs portion of the AA by computer analysis (short axis image). (b and c) The PMs were separated from the main body of AA (long axis image). (b) Main body, (c) PMs.
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Related In: Results  -  Collection

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getmorefigures.php?uid=PMC5120179&req=5

fig2: Quantification of the pectinate muscles (PMs) portion of the atrial appendages (AA) by three-dimensional morphological operation. (a) Determination of the PMs portion of the AA by computer analysis (short axis image). (b and c) The PMs were separated from the main body of AA (long axis image). (b) Main body, (c) PMs.
Mentions: For each mold, the volumes, neck areas, and surface areas of AAs were measured. After binary-coded processing was performed for all volume data in the MDCT image, we performed 3D labeling processing and decided a domain of the whole AA. Computer analysis of overall volume from the number of voxel and neck and surface areas from the number of pixels was performed. From these measurements, the neck area/volume ratio and surface area/volume ratio for each AA were calculated. Furthermore, we excised PMs from each AA by 3D morphological operations (Figure 2) [19] and quantified differences between RAA and LAA. The amount of PMs was determined from the number of voxels using computer analysis.

View Article: PubMed Central - PubMed

ABSTRACT

The three-dimensional (3D) structures of the right atrial appendage (RAA) and left atrial appendage (LAA) were compared to clarify why thrombus formation less frequently occurs in RAA than in LAA. Morphological differences between RAA and LAA of 34 formalin-preserved cadaver hearts were investigated. Molds of RAA and LAA specimens were made and the neck areas, volumes of the atrial appendages (AA), and amount of pectinate muscles (PMs) were analyzed using multidetector computed tomography. In RAA, most PMs were connected to one another and formed a “dendritic” appearance and the inner surface area was smaller than in LAA. RAA had smaller volumes and larger neck areas than LAA. The ratios of the neck area/volume were larger and the amounts of PMs were smaller in RAA than in LAA. The volumes, neck areas, and amount of PMs of RAA were significantly correlated with those of LAA. According to the 3D structure, RAA appears to be suited for a more favorable blood flow, which may explain why the thrombus formation is less common in RAA than in LAA. Examining not only LAA but also RAA by transesophageal echocardiography may be useful in high-risk patients of thrombus formation in LAA because the volume, neck area, and amount of PMs of LAA reflect the shape of RAA.

No MeSH data available.


Related in: MedlinePlus