The left atrial appendage: from embryology to prevention of thromboembolism.
The left atrial appendage (LAA) is the main source of thromboembolism in patients with non-valvular atrial fibrillation (AF). As such, the LAA can be the target of specific occluding device therapies. Optimal management of patients with AF includes a comprehensive knowledge of the many aspects related to LAA structure and thrombosis. Here we provide baseline notions on the anatomy and function of the LAA, and then focus on current imaging tools for the identification of anatomical varieties. We also describe pathogenetic mechanisms of LAA thrombosis in AF patients, and examine the available evidence on treatment strategies for LAA thrombosis, including the use of non-vitamin K antagonist oral anticoagulants and interventional approaches.
Institute of Cardiology, Campus Bio-Medico University, Rome, Italy.
Giuseppe
G
Patti
Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
Vittorio
V
Pengo
Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Rossella
R
Marcucci
Department of Advanced Biological Sciences, University Federico II, Naples, Italy.
Plinio
P
Cirillo
Institute of Cardiology, G. d'Annunzio University, Chieti, Italy.
Giulia
G
Renda
Department of Medicine and Aging, G. d'Annunzio University, Chieti, Italy.
Francesca
F
Santilli
Division of Cardiology, Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy.
Paolo
P
Calabrò
Institute of Cardiology, G. d'Annunzio University, Chieti, Italy.|G Pasquinucci Hospital, Massa, Italy.
Alberto Ranieri
AR
De Caterina
Institute of Cardiology, Campus Bio-Medico University, Rome, Italy.
Ilaria
I
Cavallari
Institute of Cardiology, Campus Bio-Medico University, Rome, Italy.
Elisabetta
E
Ricottini
Cardiology Unit, Madonna del Soccorso Hospital, San Benedetto del Tronto, Italy.|Politecnica Delle Marche University, San Benedetto del Tronto, Italy.
Vito Maurizio
VM
Parato
Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
Giacomo
G
Zoppellaro
Institute of Cardiology, Campus Bio-Medico University, Rome, Italy.
Giuseppe
G
Di Gioia
Institute of Cardiology, Campus Bio-Medico University, Rome, Italy.
Pietro
P
Sedati
Cardiology Unit, Madonna del Soccorso Hospital, San Benedetto del Tronto, Italy.
Vincenzo
V
Cicchitti
Department of Medicine and Aging, G. d'Annunzio University, Chieti, Italy.
Giovanni
G
Davì
Division of Cardiology, Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy.
Enrica
E
Golia
Division of Cardiology, Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy.
Ivana
I
Pariggiano
Department of Medicine and Aging, G. d'Annunzio University, Chieti, Italy.
Paola
P
Simeone
Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Rosanna
R
Abbate
Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Domenico
D
Prisco
Institute of Cardiology, G. d'Annunzio University, Chieti, Italy.
Marco
M
Zimarino
Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.|Don Carlo Gnocchi Foundation, Florence, Italy.
Francesco
F
Sofi
Department of Cardiovascular Science, Catholic University, Rome, Italy.
Felicita
F
Andreotti
Raffaele
R
De Caterina
D020517:Atrial Appendage / Q000033:anatomy & histology / Q000196:embryology / Q000502:physiology; D001281:Atrial Fibrillation / Q000150:complications; D001783:Blood Flow Velocity / Q000502:physiology; D004452:Echocardiography; D004730:Endothelium, Vascular / Q000502:physiology; D006801:Humans; D018810:Magnetic Resonance Angiography; D055989:Septal Occluder Device; D020521:Stroke / Q000517:prevention & control; D060205:Therapeutic Occlusion / Q000295:instrumentation / Q000379:methods; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control*; D014057:Tomography, X-Ray Computed
Anticoagulants; Atrial fibrillation; Left atrial appendage; NOACs; Non-vitamin K antagonist oral anticoagulants; Occlusion devices; Stroke; Systemic embolism; Thromboembolism