Batko Jakub, Jakiel Rafał, Krawczyk-Ożóg Agata, Jaśkiewicz Kacper, Litwinowicz Radosław, Burysz Marian, Jakiel Marcin, Bartuś Krzysztof, Bolechała Filip, Strona Marcin, Hołda Mateusz Krystian
HEART-Heart Embryology and Anatomy Research Team, Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland.
CAROL-Cardiothoracic Anatomy Research Operative Lab, Department of Cardiovascular Surgery and Transplantology, Institute of Cardiology, Jagiellonian University Medical College, Cracow, Poland.
Clin Anat. 2025 May;38(4):471-479. doi: 10.1002/ca.24246. Epub 2024 Nov 14.
The recently-described left atrial appendage (LAA) neck is a truncated cone-shaped structure that connects the LAA orifice to its lobe. It shows malformations in some cases, but their exact description and clinical significance are unknown. Therefore, the aim of this study was to provide a detailed anatomical and morphometric analysis of LAA neck malformations in clinical context. A total of 250 autopsied human hearts (20.0% women, 46.7 ± 18.2 years old) were examined for mural malformations: spikes and bulges. Endocardial roughness of the LAA neck with a depth <2 mm and no recognizable epicardial protrusion was defined as ectopic trabeculation. LAA neck malformations were found in 13.6%, bulges in 10.0% of the hearts examined, spikes in only 3.2%, and ectopic trabeculations in 24.8%. In one case, both a bulge and a spike were found in the LAA neck. Most LAA neck roughness was observed on the aortic and venous surfaces of the LAA neck. Those surfaces were the most common locations for malformations and ectopic trabeculations. The LAA wall was significantly thinner than the surrounding neck wall within the bulges and the ectopic trabeculations, but not in the spikes.
最近描述的左心耳（LAA）颈部是一个截头圆锥形结构，它将左心耳口与其叶相连。在某些情况下，它会出现畸形，但其确切描述和临床意义尚不清楚。因此，本研究的目的是在临床背景下对左心耳颈部畸形进行详细的解剖学和形态学分析。共检查了250例尸检人心（女性占20.0%，年龄46.7±18.2岁）的壁面畸形：尖峰和凸起。左心耳颈部内膜粗糙度深度<2mm且无明显的心外膜突出定义为异位小梁。在检查的心脏中，13.6%发现左心耳颈部畸形，10.0%有凸起，仅3.2%有尖峰，24.8%有异位小梁。在1例中，左心耳颈部同时发现了凸起和尖峰。左心耳颈部的粗糙度大多出现在左心耳颈部的主动脉面和静脉面。这些表面是畸形和异位小梁最常见的部位。在凸起和异位小梁内，左心耳壁明显比周围的颈部壁薄，但在尖峰处并非如此。
