{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T11:55:03Z","timestamp":1776254103677,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    The left atrial appendage (LAA) is the predominant site of thrombus formation in patients with non\u2010valvular atrial fibrillation (AF). Accurate evaluation of LAA anatomy is therefore essential for both stroke risk stratification and procedural planning in LAA occlusion (LAAO). Although clinical scores such as CHA\n                    <jats:sub>2<\/jats:sub>\n                    DS\n                    <jats:sub>2<\/jats:sub>\n                    \u2010VA guide anticoagulation strategies, they do not fully capture individual thromboembolic risk. Growing evidence indicates that LAA morphology and geometry provide incremental prognostic information beyond traditional clinical factors. Multiple studies have consistently demonstrated a lower stroke risk associated with the chicken wing (CW) morphology, whereas cauliflower, cactus, and windsock configurations are linked to higher thromboembolic risk. More recent investigations suggest that specific anatomical features\u2014such as bend angle, ostium\u2010to\u2010bend distance, ostial shape, and LAA volume\u2014may be stronger determinants of blood stasis and thrombogenesis than qualitative shape classification alone, with improved reproducibility.\n                  <\/jats:p>\n                  <jats:p>Most data on LAA morphology derive from cardiac computed tomography or magnetic resonance imaging. However, advances in three\u2010dimensional transesophageal echocardiography (3D TEE), including en face visualization, multiplanar reconstruction, and glass rendering, now enable detailed, real\u2010time, radiation\u2010free assessment of LAA anatomy. This review summarizes current evidence linking LAA morphology to thromboembolic risk and provides a practical overview of advanced 3D TEE techniques for comprehensive LAA evaluation, with step\u2010by\u2010step guidance approach.<\/jats:p>\n                  <jats:p>The LAA is the primary site of thrombus formation in AF, and the chicken\u2010wing morphology is associated with a lower risk of ischemic stroke compared with non\u2013chicken\u2010wing types. Advanced 3D TEE assessment is crucial for detailed morphological evaluation and for planning LAAO procedures. This review outlines how to evaluate the LAA using advanced 3D TEE techniques.<\/jats:p>","DOI":"10.1111\/echo.70416","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T21:27:32Z","timestamp":1773005252000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Left Atrial Appendage Morphology and Correlation With Stroke: A Narrative and Three\u2010Dimensional Transesophageal Evaluation Review"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0018-4669","authenticated-orcid":false,"given":"Sergio","family":"Suma","sequence":"first","affiliation":[{"name":"Department of Cardiology University Hospital of Parma  Parma Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emiliano","family":"Guerra","sequence":"additional","affiliation":[{"name":"Cardiac Rehabilitation Unit, Cardiac Thoracic and Vascular Department Carlo Poma Hospital  Mantua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosi","family":"Vrenozaj","sequence":"additional","affiliation":[{"name":"University of Parma  Parma Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tommaso","family":"Viva","sequence":"additional","affiliation":[{"name":"Department of Clinical Cardiology and Cardiovascular Imaging IRCCS Galeazzi\u2010Sant'Ambrogio Hospital  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Ancona","sequence":"additional","affiliation":[{"name":"Cardiovascular Imaging Unit San Raffaele Scientific Institute  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelo","family":"Squeri","sequence":"additional","affiliation":[{"name":"Department of Cardiology Cardiovascular Imaging Unit, Maria Cecilia Hospital, GVM Care &amp; Research  Cotignola Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Benfari","sequence":"additional","affiliation":[{"name":"University of Verona  \u00a0 Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corrado","family":"Fiore","sequence":"additional","affiliation":[{"name":"Department of Cardiology Citt\u00e0 Di Lecce Hospital GVM Care &amp; Research  Lecce Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Coli","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital of Parma  Parma Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniele","family":"Sartorio","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital of Parma  Parma Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura Anna","family":"Leo","sequence":"additional","affiliation":[{"name":"Cardiac Imaging Department Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale  Lugano Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Tomaselli","sequence":"additional","affiliation":[{"name":"Department of Cardiology Istituto Auxologico Italiano  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Mangini","sequence":"additional","affiliation":[{"name":"Department of Cardiology Ospedale Regionale Miulli, Acquaviva delle Fonti  Bari Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Lofrumento","sequence":"additional","affiliation":[{"name":"Department of Cardiology Citt\u00e0 Di Lecce Hospital GVM Care &amp; 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