Pathogenesis of embologenic thrombosis of the left atrium in patients with atrial fibrillation

Sotnikov A.V.; Melnikov M.V.; Ivanova V.F.; Vinnichuk S.A.; Kozhevnikov D.S.

doi:https://doi.org/10.17116/kardio202114051400

Sotnikov A.V.

Mechnikov North-Western State Medical University

Melnikov M.V.

Federal Center of Brain Research and Neurotechnologies of the Federal Medical Biological Agency;
Pirogov Russian National Research Medical University;
National Research Center Institute of Immunology of the Federal Medical Biological Agency

SPIN RSCI: 6636-6419
Scopus AuthorID: 57221797118
ORCID: 0000-0001-6880-3668

Ivanova V.F.

Mechnikov North-Western State Medical University of the Ministry of Health of Russia

Vinnichuk S.A.

Mechnikov Northwestern State Medical University

Kozhevnikov D.S.

Mechnikov North-Western State Medical University

Pathogenesis of embologenic thrombosis of the left atrium in patients with atrial fibrillation

Authors:

Sotnikov A.V., Melnikov M.V., Ivanova V.F., Vinnichuk S.A., Kozhevnikov D.S.

More about the authors

Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2021;14(5): 400‑406

DOI: 10.17116/kardio202114051400

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To cite this article:

Sotnikov AV, Melnikov MV, Ivanova VF, Vinnichuk SA, Kozhevnikov DS. Pathogenesis of embologenic thrombosis of the left atrium in patients with atrial fibrillation. Russian Journal of Cardiology and Cardiovascular Surgery. 2021;14(5):400‑406. (In Russ.)
https://doi.org/10.17116/kardio202114051400

Подписка 2026 Кардиология и сердечно-сосудистая хирургия (Russian Journal of Cardiology and Cardiovascular Surgery)

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OBJECTIVE

To study ultrastructure of the left atrium appendage endocardium in patients with atrial fibrillation regarding the predisposing factors for local embologenic thrombosis.

MATERIAL AND METHODS

There were 1807 patients with embolism of the aorta and lower limb arteries who underwent surgery at the Hospital of General Surgery of the Mechnikov North-Western State Medical University over the past 30 years. In 1604 (88.8%) cases, atrial fibrillation (AF) was one of the main causes of this complication. Thrombi were usually located in the left atrial appendage. We analyzed ultrastructure of the left atrial appendage endocardium in 67 patients with AF using light and electron microscopy. Tissue samples were obtained during open cardiac surgery for structural coronary and/or valvular diseases. Left atrial appendage resection was additionally carried out to prevent arterial embolism in long-term period.

RESULTS

Patients with long-standing AF had progressive irreversible structural alterations in the endocardium with degeneration and desquamation of endothelial cells, as well as sub-endocardial edema. These alterations resulted embologenic parietal thrombosis in some cases. We consider the advantages and disadvantages of modern conservative and surgical methods for prevention of arterial embolism from the left atrial appendage in patients with AF.

CONCLUSIONS

Despite modern advances in prevention of arterial embolism in patients with AF, a reliable and safe solution of this problem has not yet been found. Further researches in this direction are required.

Keywords:

atrial fibrillation

left atrial appendage

arterial embolism

Authors:

Sotnikov A.V.

Mechnikov North-Western State Medical University

Melnikov M.V.

SPIN RSCI: 6636-6419
Scopus AuthorID: 57221797118
ORCID: 0000-0001-6880-3668

Ivanova V.F.

Mechnikov North-Western State Medical University of the Ministry of Health of Russia

Vinnichuk S.A.

Mechnikov Northwestern State Medical University

Kozhevnikov D.S.

Mechnikov North-Western State Medical University

Received:

13.11.2020

Accepted:

09.02.2021

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References:

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