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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.


Pectinate muscles (PMs) in right atrial appendage (RAA) and left atrial appendage (LAA). A comparison whether there is intercommunication between PMs. (a)-1,2 PMs in RAA (traffic); (b) PMs in LAA (no traffic). TS: tenia sagittalis.
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fig3: Pectinate muscles (PMs) in right atrial appendage (RAA) and left atrial appendage (LAA). A comparison whether there is intercommunication between PMs. (a)-1,2 PMs in RAA (traffic); (b) PMs in LAA (no traffic). TS: tenia sagittalis.

Mentions: The inner surfaces of both RAA and LAA are characterized by PMs. There are significant differences between RAA and LAA; as in RAA, most PMs are connected to one another and form a “dendritic” appearance. In contrast, connections between neighboring PMs are less pronounced in LAA (Figure 3).


Structural Comparison between the Right and Left Atrial Appendages Using Multidetector Computed Tomography
Pectinate muscles (PMs) in right atrial appendage (RAA) and left atrial appendage (LAA). A comparison whether there is intercommunication between PMs. (a)-1,2 PMs in RAA (traffic); (b) PMs in LAA (no traffic). TS: tenia sagittalis.
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Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC5120179&req=5

fig3: Pectinate muscles (PMs) in right atrial appendage (RAA) and left atrial appendage (LAA). A comparison whether there is intercommunication between PMs. (a)-1,2 PMs in RAA (traffic); (b) PMs in LAA (no traffic). TS: tenia sagittalis.
Mentions: The inner surfaces of both RAA and LAA are characterized by PMs. There are significant differences between RAA and LAA; as in RAA, most PMs are connected to one another and form a “dendritic” appearance. In contrast, connections between neighboring PMs are less pronounced in LAA (Figure 3).

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.