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. 2022 Jul 20;55(5):364–377. doi: 10.5090/jcs.22.030

Fig. 5.

Fig. 5

(A) Inner wall of the left atrium after sectioning the middle of the anterior (aortic) mitral leaflet. (B) Close-up view of the left lateral wall of the left atrium of the same specimen as in (A). The atrial wall is sectioned at the junction between the septal and left lateral walls. Bachmann’s bundle is cut at its main part to the left. The 3 branches of the left part of Bachmann’s bundle are shown as L-1, L-2, and L-3. L-1 runs upward between the right and left upper pulmonary veins (LUPVs). L-2 runs to the lateral ridge between the LUPV and the left atrial appendage (LAA). L-3 is at the vestibule of the left atrium over the mitral valve. The location of the annulus of the mitral valve from the left atrial aspect is marked in red dotted lines. Three isthmus lines for left atrial ablation are shown by yellow dotted lines. The posterior lateral isthmus line (PL) between the left lower pulmonary vein and the mitral annulus (red dotted lines) is the shortest line to cut L-3 of the mitral vestibule. The antero-lateral isthmus line (AL) is between the LUPV and the mitral annulus, and the procedure blocks L-3 and L-2 at the lateral ridge. The anterior medial isthmus line (AM) is between the right upper pulmonary vein (RUPV) and the mitral annulus, blocking all 3 branches of Bachmann’s bundle (L-1, L-2, and L-3). (C) A 3-dimensional (3D)–printed heart showing the inferior wall of the left atrium. There is a wide space at the inferior wall between the annulus at the posterior mitral leaflet and the inferior pulmonary veins. The coronary sinus runs along the inferior wall of the left atrium. (D) A different view of the 3D-printed heart sectioned on another plane, similar to the view shown in (B). LV, left ventricle; AML, anterior leaflet of the mitral valve; PML, posterior leaflet of the mitral valve; AoV, aortic valve; RLPV, right lower pulmonary vein; LLPV, left lower pulmonary vein; LC, left coronary cusp; RC, right coronary cusp; NC, non-coronary cusp; CS, coronary sinus; Eso., esophagus; Desc. Ao, descending aorta; RA, right atrium; RV, right ventricle.