title: Variability of the Left Atrial Appendage in Human Hearts.
abstract: Atrial fibrillation increases the risk of thrombus formation. It is commonly responsible for cerebral stroke whereas less frequently for pulmonary embolism. The aim of the study was to describe the morphology of the left atrial appendage in the human heart with respect to sex, age and weight. Macroscopic examination was carried out on 100 left appendages taken from the hearts of the patients aged 18-77, both sexes. All hearts preserved in 4% water solution of formaldehyde carried neither marks of coronary artery disease nor congenital abnormalities. Three axes of appendage orientation were performed. After the appendage had been cut off, morphological examination was performed in long and perpendicular axes. Measurements of the appendages were taken from anatomical specimens and their silicone casts. We classified the left atrial appendage into 4 morphological groups according to the number of lobes. Most left atrial appendages in female population were composed of 2 lobes. In the male group typically 2 or 3-lobed appendages were observed. The mean left atrial appendage orifice ranged from 12.0 to 16.0 mm and the most significant difference in the orifices between males and females was observed in LAA type 2 (about 3.3 mm). A smaller orifice and narrower, tubular shape of the LAA lobes could explain a higher risk of thrombus formation during nonvalvular atrial fibrillation in women. Knowledge of anatomical variability of the LAA helps diagnose some undefined echoes in the appendage during transesophageal echocardiographic examination.
authors.affiliation: Department of Clinical Anatomy, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Rafał
authors.initials: R
authors.lastname: Kamiński
authors.affiliation: Department of Clinical Anatomy, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Kosiński
authors.affiliation: Department of Cardiology and Electrotherapy, Hospital of Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Mariola
authors.initials: M
authors.lastname: Brala
authors.affiliation: Department of Clinical Anatomy, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Piwko
authors.affiliation: Department of Cardiology and Electrotherapy, Hospital of Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Lewicka
authors.affiliation: Department of Cardiology and Electrotherapy, Hospital of Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Alicja
authors.initials: A
authors.lastname: Dąbrowska-Kugacka
authors.affiliation: Department of Cardiology and Electrotherapy, Hospital of Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Raczak
authors.affiliation: Department of Cardiology and Electrotherapy, Hospital of Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Kozłowski
authors.affiliation: Department of Clinical Anatomy, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Grzybiak
mesh_terms: D000375:Aging; D020517:Atrial Appendage / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D012727:Sex Characteristics