We a clear image of the Oblique Vein of Marshall during ICE-guided LAAO. What do we know about this structure?

1) In 1850, a surgeon described a pericardial fold containing fibrous bands,vessels & nerves that courses between LAA & PVs (ligament of Marshall; LOM)

2) The vein of Marshall (VOM), an embryological remnant of the left superior vena cava, runs in the LOM & drains into the coronary sinus

3) An arrhythmogenic role of the VOM has been confirmed in several studies https://doi.org/10.1016/S0735-1097(00)00819-6

4) Recent studies have suggested that catheter-based Ethanol ablation of the VOM may improve the outcomes of PV ablation for AF. https://jamanetwork.com/journals/jama/fullarticle/2772281

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