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Aim <p>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.</p> Materials and methods <p>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.</p> Results <p>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 (<i>p</i> = 0.0177). Within the 60 patients with LAA clot, windsock (50%) was the commonest morphology.</p> Conclusion <p>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&#xa0;cm/s and the EOD exceeds 25&#xa0;mm. Such a combination identifies individuals at distinctly increased risk for future LAA thrombus development and AF, warranting proactive monitoring and potential early intervention.</p>

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Left atrial appendage morphology, characteristics and its relation with left atrial appendage clot and atrial fibrillation in patients with valvular heart lesions

  • 期刊论文

  • 发表日期：

    2026年5月29日

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  • Saurabh Jagtap,
  • Sushrut Potwar,
  • Heli Oza,
  • Abhishek Potnis,
  • Uday Eknathrao Jadhav,
  • Avinash Gonnade

摘要

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.