Ligament of Marshall
The Ligament of Marshall (LoM) is a complex of muscle bundles, blood vessels, adipose tissue, fibrous structure, ganglia, and nerves between the left atrial appendage and the left superior pulmonary vein.[1][2] The LoM consists of the Vein of Marshall (VoM), a band of muscle called to Marshall Bundle (MB), and the epicardial ganglionated plexi.[1]
Ligament is fibrous connective tissue between bones, so "ligament" in "Ligament of Marshall" is a misnomer.
Atrial fibrillation
[edit]Pulmonary vein isolation has been the mainstay of atrial fibrillation reduction, but in many cases there are other sources of arrhythmia, including the LoM.[1][3] Use of ethanol through the VoM has been shown to be an effective way to reduce atrial fibrillation.[4]
Discovery
[edit]The LoM was discovered in 1850 by British surgeon John Marshall, which was later named in his honor.[1]
References
[edit]- 1 2 3 4 Corradi D, Callegari S, Macchi E (2016). "Morphology and pathophysiology of target anatomical sites for ablation procedures in patients with atrial fibrillation: part II: pulmonary veins, caval veins, ganglionated plexi, and ligament of Marshall". International Journal of Cardiology. 168 (3): 1769–1778. doi:10.1016/j.ijcard.2013.06.141. PMID 23907042.
- ↑ Stavrakis S, Po S (2017). "Ganglionated Plexi Ablation: Physiology and Clinical Applications". Arrhythmia & Electrophysiology Review. 6 (4): 186–190. doi:10.15420/aer2017.26.1. PMC 5739885. PMID 29326833.
- ↑ Rodríguez-Mañero M, Schurmann P, Valderrábano M (2016). "Ligament and vein of Marshall: A therapeutic opportunity in atrial fibrillation". Heart Rhythm. 13 (2): 593–601. doi:10.1016/j.hrthm.2015.10.018. PMC 4796610. PMID 26576705.
- ↑ Li F, Sun J, Wang R (2022). "The Long-Term Outcomes of Ablation With Vein of Marshall Ethanol Infusion vs. Ablation Alone in Patients With Atrial Fibrillation: A Meta-Analysis". Frontiers in Cardiovascular Medicine. 9 871654. doi:10.3389/fcvm.2022.871654. PMC 9098965. PMID 35571170.
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