110Figure 9 Variations in the ligament of Marshall (LOM) anatomyVariations of LOM(ligament of Marshall) anatomy. A black circle in A1 indicates the proximal connection of the LOM to the CS. A2: A different view of the same heart. The distal end of the LOM inserts into the LSPV. A3: A second heart in which LOM was completely attached to the epicardium. A discrete ligament was not identified. B1: Proximal connection (arrow) between the LOM and the CS. B2: Both the proximal and distal connections of the LOM (2 arrows) in a second heart. B3: A third heart, which seems to have multiple muscle fibers (arrows) connecting the LOM and the LA.Reprinted from Hwang C, Chen PS. Ligament of Marshall: why it is important for atrial fibrillation ablation. Heart Rhythm. 2009; 6(12 Suppl): S35-40.Figure 10 The impact of surgical left atrial appendage amputation/ligation on stroke prevention in patients undergoing off-pump coronary artery bypass grafting.A: Stroke-free survival curveLAA: left atrial appendagePOSR: postoperative sinus rhythmPOAF: postoperative atrial fibrillation
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