samedi 21 mars 2015

Cas du 21/03/2015: Left Atrial Appendage Velocity

Presentation: We did a PWD of a LA appendage and had a forward velocity of 17 cm/s and a negative velocity of 13-17 cm/sec.





#1: Discuss the normal and abnormal left atrial velocities and their significance?



























Explanation: If the velocity of the LAA is low, one would expect that stasis and an environment for thrombus formation would be present. Where you measure LAA velocity is important.  The velocity is higher 1 cm below the LAA orifice than 1 cm from the LAA apex.  The normal LAA velocity exceeds 50 cm/sec.

In patients with atrial fibrillation, the LAA emptying velocity drops.  One study found that elderly patients with low LVEF (< 40%) and a LAA  velocity (LAAV) < 20 cm/sec were more likely to develop LAA thrombi. A TTE will measure about the same velocities as TEE so the modality is not important.  One study showed that TTE measured LAAV at 50 cm/sec were measured at 47 cm/sec.

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