Assessment of Left Atrium Appendage Morphology by 3D Transesophageal Echocardiography and Itʼs Relation to Thrombus Formation

Objective: This study was to assess different LAA shapes by 3D TEE and to find the relationship between the morphology of the LAA and the incidence of SEC and thrombus formation. Patients and methods: this is prospective cross sectional study included sixty patients underwent 2D & 3D TEE and assessed for LAA morphology and presence of SEC or thrombus. Results: regarding different shapes of LAA we found21windsock (35.1%), 17 cactus (28.3%) ,11 chicken wing (18.3%)and 11 cauliflower 11(18.33%). Thrombus found in 3 cases (5.0%), SEC in 15 cases (25.0%). There is significant association between morphology of LAA and presence of SEC; which noticed only in non – chicken wing shapes (7 in cauliflower, 5 in windsock, 3 in cactus and 0 in chicken wing) . There is significant association between morphology of LAA and thrombus formation; the 3 thrombus were found in cactus (100%) and regarding number of LAA lobes that bi lobed were the most common in 41.66% of cases, then single lobed in 33.33% of cases and the least common were multi lobed. There is significant relationship between shape of LAA and orifice area (p-value =0.009); cauliflower associated with the largest orifice area and chicken wing with the smallest orifice area. The cauliflower had the largest number of lobes 3-5, the smallest number of lobes associated with windsock 1-2. Conclusion: 3D TEE provide detailed assessment of LAA shapes and it’s special anatomical characteristic. In our study, non-chicken wing LAA shapes was associated with higher prevalence of SEC and thrombus.