Masters of Clinical Anatomy Projects
The left atrial appendage (LAA) is an area of interest because of its thrombogenic potential in patients with atrial fibrillation. The current standard for LAA removal is epicardial excision, which may leave residual volume thereby undermining its effectiveness. Also, LAA surgery may injure the nearby circumflex artery. This investigation aims to measure the proximity of the circumflex artery to the LAA at various points, and evaluate pericardial patch exclusion as a novel method of LAA closure in a cadaveric model. After performing both procedures in all (n=27) hearts, epicardial excision left 24% of the original volume while pericardial patch exclusion left 4%. The circumflex artery was closest to the LAA at the 4 o’clock position. These results suggest that physicians should beware of the injuring the circumflex artery at 4 o’clock and that pericardial patch exclusion may be a viable alternative for surgical LAA closure in patients with atrial fibrillation.