Análise morfológica e clínica do apêndice atrial esquerdo de pacientes de um centro único em Palmas, Tocantins

Abstract

Despite the clinical relevance of the left atrial appendage (LAA), there is a scarcity of data on its morphology in Brazil. This study evaluated the prevalence of LAA morphological patterns in patients from a diagnostic center in Palmas, Tocantins, and correlated them with clinical data. A total of 500 coronary CT angiographies were analyzed from October 2023 to February 2025. Variables assessed included orifice size, number of lobes, and morphology, as well as pre-existing comorbidities. The sample consisted of 242 women (48.4%) and 258 men (51.6%), with a mean age of 61.7 years. The identified morphological variants were: Cactus (38.6%), Windsock (32.4%), Cauliflower (14.8%), and Chicken Wing (14.2%). The female group showed a higher prevalence of the Cactus morphology (34.25%), while the male group showed a higher prevalence of the Windsock morphology (24.36%), with statistical significance (p < 0.05). The unilobed pattern was predominant (59.8%), followed by bilobed (16.4%) and multilobed (23.8%) patterns. The mean LAA diameter was 18.93 mm in women and 19.42 mm in men, with a statistically significant difference (p < 0.05). It is concluded that the morphological characterization of the LAA may aid in prevention, treatment strategies, and the management of occlusion procedures, contributing to the reduction of cardiovascular events.

Keywords: Left Atrial Appendage. Anatomy. Tomography. Atrial fibrillation.