[Characterization of Doppler flow of the left atrial appendage and its relation to thrombi. A transesophageal echocardiographic study].

OBJECTIVE

The characteristics and clinical implications associated with Left Atrial Appendage (LAA) flow have not been clearly analyzed. The purpose of this transesophageal pulsed doppler study was to evaluate the importance of rhythm and echo doppler parameters on LAA thrombus formation.

DESIGN

Prospective study.

SETTING

Patients in a follow-up transesophageal echocardiographic study at Gregorio Maranon General Hospital, Madrid.

PATIENTS

Through a transesophageal echocardiographic color Doppler prospective study we evaluated 44 consecutive patients.

INTERVENTIONS

In each patient we measured presence of atrial fibrillation, presence of LAA thrombi and LAA doppler flow pattern parameters (peak velocity and area enclosed by the pulsed doppler filling and emptying waves).

MEASUREMENTS

We identified three types of LAA doppler flow: Type I, clearly defining biphasic flow, was present only in sinus rhythm patients and not associated to LAA thrombus; Type II saw-fish active flow pattern was detected only in atrial fibrillation patients not associated also with LAA thrombus. Type III low flow pattern occurred only in atrial fibrillation patients and is associated to the majority of LAA thrombus.

CONCLUSIONS

These findings document the importance of LAA doppler factors when transesophageal echocardiography is used to study LAA thrombus formation.