The Left Atrial Appendage Revised

Figures

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  Fig. 1. Bioassay system from the perfused atrial appendage tube. The atriums are perfused through a separate constant-flow perfusion loop, and vasoactivity of effluent from the atriums was bioassayed on a ring of canine coronary artery. The central cannula was used to direct perfusion of coronary rings (physiologic solution with or without drugs). The lateral cannulae were connected to the right and left atrium and the solution perfused thought atrial tubes was dripped on coronary ring. The coronary ring was connected to a force transducer that registers the variation of vascular tone (contraction and relaxation)[10].

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  Fig. 2. Representative recording of change in contraction of canine coronary artery ring with endothelium superfused with effluent from atrial appendage tubes infused with A23187. Relaxation was inhibited when the ring was superfused with L-NMMA (A) and when the endothelium was removed (B) [10].

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  Fig. 3. Bioassay of calcium ionophore-induced promote relaxation in the right and left atrium. The vasodilator activity of effluent from the right and left atrial appendage was blocked 85.1 ± 7.9% and 88.9±3.5%, respectively, by the presence of the L-NMMA (10-M) in rings contracted with PGF 2 (2x10 M). Results are reported as means±SEM. * indicate significant difference between with and without L-NMMA groups (P<0.001)[10].

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  Fig. 4. Surgical technique. A - Purse-string suture avoiding the left atrial appendage; B - The purse-string suture is tied up taking care not to be overtight, because the aim is to delineate the rims, not to obliterate the orifice completely; C - Finally, a second "out-out" running suture carried out and then tied up; D - Final aspect.