An impairment of the left atrial function similar to that one generally observed by echocardiography in atrial fibrillation (AF) has been reported in patients with patent foramen ovale (PFO) and permanent right-to-left shunting (RLS) [1]. Computational fluid dynamic (CFD) studies have suggested that in left atrial appendage (LAA) vortices generated in the chamber remain high strengths and with longer durations in patients with AF, inducing ineffective emptying of the blood in the atrium and appendage, which then lead to blood stagnation and subsequent thrombus formation [2].
