Left Atrium and Pulmonary Veins Outline

Left Atrial Anatomy

• Introduction
• Anatomy

Left Atrial Function

• LA Function
• Phase I
• Phase II
• Phase III
• Phase IV
• Spontaneous Respiration Effect
• Positive Pressure Ventilation Effect

Left Atrial Views

• Left Atrium Views
• Left Atrial Appendage Views

Pulmonary Vein Views

• Left Upper Pulmonary Veins
• Left Lower Pulmonary Veins
• Right Upper Pulmonary Veins
• Right Lower Pulmonary Veins

2D Evaluation of the Left Atrium

• Left Atrial Size
• Left Atrial Volume
• Left Atrial Enlargement
• Decreased Left Atrial Size
• Emptying Volume
• Atrial Septal Displacement
• Pectinate Muscles
• Coumadin Ridge
• Spontaneous Echo Contrast
• Tumors

Congenital Defects

• Atrial Septal Defects
• Anomalous Pulmonary Venous Return
• Interatrial Septal Aneurysms
• Pulmonary Venous Obstruction

Doppler Evaluation

• Left Atrial Appendage
• Pulmonary Veins
  • Waves
    • Early Systolic Wave (PVS1)
    • Late Systoic Wave (PVS2)
    • Diastolic Wave (PVd)
    • Atrial Wave ( PVa)
  • Normal Velocities and VTI

Pulmonary Vein Flow Factors

• Factors
• Age
• Loading Conditions
• Left Atrial Pressure
• Mitral Regurgitation
• Diastolic Dysfunction
• Heart Rate
• Heart Rhythm
• Mechanical Ventilation

Technical Considerations

• TEE vs TTE
• Sample Position
• Sample Volume Size
• Pulmonary Vein Size