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Surgical left atrial appendage ligation is frequently incomplete: a transesophageal echocardiographic study

^a Department of Medicine, Division of Cardiology, New York University School of Medicine, New York, New York, USA

View larger version (57K): [in a new window]   Figure 1 (A) Transesophageal echocardiogram, transverse plane, of an incompletely ligated LAA. Color flow traverses the separation between the LAA and the left atrial body (bold arrow). The ligation suture line is shown with thin arrows. (B) Vertical plane transesophageal echocardiogram of a patient with a mitral mechanical prosthesis and an incompletely ligated LAA. Note the presence of spontaneous echo contrast (arrow) in the LAA compared with the relative absence of this finding in the left atrial body. (C) Vertical plane transesophageal echocardiogram of a patient with a mitral bioprosthesis and an incompletely ligated LAA. Thrombus is seen within the appendage (arrow). LA = left atrium; LAA = left atrial appendage; MV = mitral valve.