Особенности локальной топографии левого ушка сердца взрослого человека

Abstract

Abstract Background. Adjacent anatomy of the left atrial appendage (left cardiac auricle) is of clinical significance for radiofrequency ablation and surgical interventions on the left atrium for cardiac arrhythmias as well as for occlusion of the mouth of the appendage in order to prevent thromboembolism. We aimed to investigate the adjacent anatomical features of the left atrial appendage in human adults. Materials and methods. We studied 20 formaldehyde-preserved heart specimens of mature and elderly people who died from non-cardiac diseases. Specimens with macroscopic signs of pathology have been excluded. We used a caliper for measurements. Results. We distinguished three topographic variants of the left atrial appendage apex. Commonly (7 of 15) the apex lay on the anterior wall of the subpulmonary infundibulum. Rarely it looked upward and to the right, touching the pulmonary trunk, or lay on the anterior interventricular sulcus or slightly left of it. Two auricles had no apex, and three others had two tips. It was found to be direct correlation between the distance from the left atrial appendage to the heart apex and the length of the ventricular complex. The width of the ventricular complex correlated with the distances from the left to the right auricles and to the ascending aorta. We have found no correlation between these values and parameters of intra-atrial topography of the left atrial appendage. The paper presents medians and variability ranges of the adjacent anatomy of the appendage. The length of the left atrial appendage isthmus was found to be 10% of the length of ventricular complex. That morphometric ratio will allow predicting the intra-atrial position of the mouth without intracardiac interventions. Conclusion. Adjacent anatomy of the left atrial appendage showed individual anatomical variability. The variability expressed in such signs as follows: three topographical variants for the apex, certain proportions of morphometric parameters and correlation relationships. Values of the unidirected measured parameters showed close direct correlations.