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Two Cases of Incidentally Diagnosed Idiopathic Left Atrial Appendage Ostial Stenosis

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초록

We report here on 2 cases of idiopathic left atrial appendage ostial stenosis (LAA), and this rare finding was detected on transesophageal echocardiography. Its clinical implication is still unknown, given the small number of reported cases. Incompletely ligated LAA has characteristics similar to those observed in idiopathic LAA ostial stenosis, including the narrowed orifice, the small LAA cavity and the accelerated blood flow across the stenotic area. Since the incompletely ligated LAA has been reported to be complicated with thromboembolic events, we can assumed that the patients with idiopathic LAA ostial stenosis have a higher risk of thromboembolism than those with a normal LAA structure.

Abstract

We report here on 2 cases of idiopathic left atrial appendage ostial stenosis (LAA), and this rare finding was detected on transesophageal echocardiography. Its clinical implication is still unknown, given the small number of reported cases. Incompletely ligated LAA has characteristics similar to those observed in idiopathic LAA ostial stenosis, including the narrowed orifice, the small LAA cavity and the accelerated blood flow across the stenotic area. Since the incompletely ligated LAA has been reported to be complicated with thromboembolic events, we can assumed that the patients with idiopathic LAA ostial stenosis have a higher risk of thromboembolism than those with a normal LAA structure.

참고문헌 (8)

  1. Veinot JP, "Anatomy of the normal left atrial appendage: a quantitative study of age related changes in 500 autopsy hearts: implications for echocardiographic examination", Circulation, 96, pp.3112~3115 (1997)
  2. Coughlan B, "Left atrial appendage stenosis", J Am Soc Echocardiogr, 12, pp.882~883 (1999)
  3. Stern JD, "Isolated left atrial appendage ostial stenosis", Eur J Echocardiogr, 10, pp.702~703 (2009)
  4. Rosenzweig BP, "Thromboembolus from a ligated left atrial appendage", J Am Soc Echocardiogr, 14, pp.396~398 (2001)
  5. Oneglia C, "Transesophageal investigation of surgically ligated left atrial appendage", Echocardiography, 21, pp.617~619 (2004)
  6. Katz ES, "Surgical left atrial appendage ligation is frequently incomplete: a transesophageal echocardiographic study", J Am Coll Cardiol, 36, pp.468~471 (2000)
  7. Kanderian AS, "Success of surgical left atrial appendage closure: assessment by transesophageal echocardiography", J Am Coll Cardiol, 52, pp.924~929 (2008)
  8. Cha TJ, "Assessment of left atrial appendage flow pattern using multiplane transesophageal echocardiography in patients with nonrheumatic atrial fibrillation and ischemic stroke", J Korean Soc Echocardiogr, 5, pp.103~114 (1997)

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