J Cardiovasc Ultrasound.  2010 Sep;18(3):112-114. 10.4250/jcu.2010.18.3.112.

Two Cases of Incidentally Diagnosed Idiopathic Left Atrial Appendage Ostial Stenosis

• Kim S
• Shim WJ
• Park SM
• Kim MN
• Lee KN
• Choi YJ
• Hong H
• Kim TH
• Kim CH

• KMID: 2177311
• DOI: http://doi.org/10.4250/jcu.2010.18.3.112

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.

Keyword

Left atrial appendage; Ostial stenosis

MeSH Terms

Atrial Appendage
Constriction, Pathologic
Echocardiography, Transesophageal
Humans
Thromboembolism

Figure

• 

  Fig. 1 Transesophageal echocardiography of the case 1 revealed a small tubular shaped left atrial appendage with a narrowed orifice, and the maximal diameter of the orifice was only 4.8 mm (A). Doppler examination showed significant flow acceleration across the stenotic area with a peak velocity more than 100 cm/sec (B and C). LA: left atrium, LAA: left atrial appendage, LV: left ventricle.

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  Fig. 2 Transesophageal echocardiography of the case 2 revealed a long tubular shaped left atrial appendage with a narrowed orifice, and the maximal diameter of the orifice was only 3.8 mm (A). The peak velocity across the narrowed orifice measured more than 110 cm/sec with flow acceleration on Doppler echocardiography (B and C). LA: left atrium, LAA: left atrial appendage, LV: left ventricle.

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