Why the study?
Data on left atrial appendage characteristics in patients with mitral valve disease and atrial fibrillation are limited compared to non-valvular atrial fibrillation.
In AF patients with severe mitral valve disease, LAA morphology differs from non-valvular AF, and those with mitral stenosis have a significantly higher risk of LAA stasis and thrombus despite smaller LAA volumes compared to those with mitral regurgitation.
Despite smaller LAA volumes, mitral stenosis predominance associates with higher thrombus risk; hypothesis-generating for tailored strategies in valvular AF.
PURPOSE: The morphological and functional characteristics and clinical significance of the left atrial appendage (LAA) are well established in patients with non-valvular atrial fibrillation (AF). However, data on the LAA characteristics in patients with mitral valve (MV) disease are limited. This study aimed to identify the LAA characteristics in AF patients with severe MV disease. MATERIALS AND METHODS: A total of 506 AF patients who underwent cardiac computed tomography (CT) as preoperative evaluations for MV surgery were retrospectively analyzed. The prevalences of different LAA morphologies (cactus, cauliflower, windsock, chicken wing), LAA ostium diameter, LAA volume, and LAA flow stasis or thrombus were assessed. The LAA variables were compared according to the predominant MV dysfunction. RESULTS: <0.001] were remarkably prevalent in these patients. CONCLUSION: Due to advanced LAA remodeling in AF patients with severe MV disease, the morphologic distribution of LAA types differs from that established in patients without MV disease.
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Lee et al. (2025) studied this question.
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