How should the diameter of the left atrial appendage be determined during measurements?

Determining the diameter of the left atrial appendage (LAA) is crucial for proper assessment and intervention planning. The correct approach is to select the largest diameter measured. This is important because the LAA can have an irregular shape, and measuring just one specific section may not represent its overall size accurately. By choosing the largest measurement, clinicians ensure that they account for the maximum potential size of the appendage, which is vital for appropriate device sizing and ensuring effective occlusion.

This method helps to identify the maximum extent of the LAA, directing the intervention to avoid underestimation of its size, which could lead to complications or ineffective treatment. It also takes into consideration anatomical variations that could affect the outcomes of the procedure. In contrast, focusing on the smallest measurement would not provide adequate data for device selection and could increase the risk of device-related complications.