Auricular appendage

The atrial ( auriculae atrii ) or atrial ears are protuberances on the courts ( atria ) of the heart of man and mammals. The right auricle ( auricula dextra ) lies next to the ascending aorta , the left one ( auricula sinistra ) next to the trunk of the pulmonary artery ( Truncus pulmonalis ). The left atrial appendage is a common site for blood clots that can lead to a stroke in patients with atrial fibrillation . The right atrial appendage is a possible site for thrombus formation, which can lead to pulmonary embolism . The development of pulmonary embolisms due to clots formed in the right atrium is, however, low compared to pulmonary embolisms of other causes.

The biological function of the auricle is not yet fully understood. It is known that they are the place where a hormone produced by the heart is produced: the atrial natriuretic peptide (ANP). It causes diuresis , an increased excretion of water, in the kidney . ANP is increasingly released when the atria are more strongly distended. This reduction in fluid volume enables the heart to relieve itself of blood volume.

Atrial appendage closure

Atrial appendage closure with the Amplatzer system in the X-ray image in a 69-year-old.

For treatment, there is the option of left atrial appendage occlusion or left atrial appendage occlusion. The presence of simultaneous contraindications (e.g. bleeding) is checked in patients with atrial fibrillation and who have necessary blood thinning . Optionally, an atrial appendage closure can with a so-called Vorhofohr- occluder ( English : LAA occluders) to be made. Such an implantation of a permanent embolic protection system is intended to prevent ischemic strokes.

The implantation of the atrial appendage closure ( e.g. Amplatzer system) takes place in a cardiac catheter laboratory under deep sedation and local anesthesia. The inguinal vein is then punctured and, after a transseptal puncture, the atrial appendage closure is placed and unfolded via a catheter in the left atrial appendage. This is controlled by fluoroscopy and transesophageal echocardiography (TEE).

Individual evidence

1. ↑ Johannes W. Rohen , Elke Lütjen-Drecoll : Functional anatomy of humans. Textbook of macroscopic anatomy according to functional aspects. 11th, revised and expanded edition. Schattauer, Stuttgart et al. 2006, ISBN 3-7945-2440-3 , p. 164 ff.