Echocardiography for left atrial appendage structure and function

For long, it was believed that the left atrial appendage (LAA) was a vestigial structure e a structure which apparently did not have any meaningful function in normal life and could be easily obliterated during cardiac surgery without producing any ill effects.Studying the function of LAA could therefore be of hardly any interest.However, with the advancements of echocardiographic techniques, it has now become apparent that the LAA is an actively contracting structure which likely plays an important role in cardiac hemodynamics.More importantly, dysfunction of LAA is the substrate for thrombus formation which can lead to potentially devastating embolic complications.1e5 Accordingly, a comprehensive assessment of LAA structure and function is now regularly sought to guide therapeutic decision-making in a number of cardiac illnesses.Echocardiography, particularly transesophageal echocardiography (TEE), is currently the modality of choice for evaluation of the LAA.It allows complete delineation of the LAA anatomy in almost all patients and, at the same time, also permits a detailed assessment of its function. 1.