Abstract
Introduction The left atrial appendage is the site of origin of thrombi in 90% of cardioembolic
stroke. Although literature reports a higher risk of cardioembolic stroke among blacks
and females, it is unclear whether this is due to preponderance of specific left atrial
appendage morphologies in these groups since there is paucity of data. This study
describes the left atrial appendage morphology in a Black Kenyan population and assesses
for existence of gender differences.
Materials and Methods Ninety one (91) human hearts (50 male and 41 female) were obtained from autopsy specimens
after ethical approval. The morphological types of the left atrial appendage were
determined and classified as cauliflower, Windsock, Chickenwing and cactus. Data were
analyzed using Statistical Package for Social Sciences. The frequencies of the morphological
types was determined and Chi square applied to check for gender differences. A p-value
of < 0.05 was considered statistically significant at 95% confidence interval.
Results and Conclusion There were 27 cauliflower (29.7%), 26 Windsock (28.6%), 25 Chickenwing (27.4%) and
9 cactus (14.3%) morphological types of left atrial appendage. Cauliflower and cactus
types were more prevalent in males, while Windsock and Chickenwing types were more
prevalent in females (p = 0.537). There are no statistically significant gender differences in the left atrial
appendage morphology types in this sample black Kenyan population. The higher frequency
of both the risky cauliflower and the protective Chickenwing morphologies warrants
assessment of left atrial appendage morphological types in management of high risk
cardioembolic stroke patients in this setting.
Keywords
left atrial appendage - gender - blacks
