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Miranda J, Villalobo DM, Alfieri N, Contreras B, Vergara G. Prenatal Diagnosis of a Right Atrial Appendage Aneurysm: Case Report and Review of the Literature. AJP Rep 2024; 14:e170-e176. [PMID: 38835673 PMCID: PMC11150053 DOI: 10.1055/s-0044-1787066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 03/27/2024] [Indexed: 06/06/2024] Open
Abstract
Introduction Congenital malformations of the right atrium are rare heart defects with only a few cases described prenatally. Early diagnosis of these anomalies is becoming increasingly important for proper follow-up and due to the possibility of serious complications such as supraventricular arrhythmia, thromboembolic events, and sudden death. Objective The atrial appendage aneurysm (AAA) is a dilatation of the atrial appendage. It is considered an extremely rare congenital anomaly. However, this condition is clinically significant because it leads to atrial arrhythmias, recurrent emboli, heart failure, and chest pain. In addition, it is possible to recognize AAA prenatally with fetal echocardiography, even if it rarely happens. However, few fetal AAA cases have been reported in the literature. Study Design We report a case of a fetal AAA; diagnosed prenatally and with postnatal confirmation. We undertook a systematic review of studies on fetal AAA to synthesize available knowledge on diagnosing and managing this rare condition. Results A total of eight studies describing 24 patients were identified and analyzed. Conclusion Despite their rarity, fetal atrial appendage aneurysms necessitate early detect on due to associated severe complications. Our findings emphasize the importance of prenatal diagnosis through fetal echocardiography and highlight the need for further research to optimize management strategies and improve outcomes for affected individuals.
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Affiliation(s)
- Jezid Miranda
- Department of Obstetrics and Gynecology, Grupo de Investigación en Cuidado Intensivo y Obstetricia (GRICIO), Universidad de Cartagena, Cartagena de Indias, Colombia
- Department of Obstetrics and Gynecology, Centro Hospitalario Serena del Mary Fundacion Santa Fe, Cartagena de Indias, Colombia
| | - Dulce María Villalobo
- Department of Obstetrics and Gynecology, Grupo de Investigación en Cuidado Intensivo y Obstetricia (GRICIO), Universidad de Cartagena, Cartagena de Indias, Colombia
| | - Nikita Alfieri
- Department of Obstetrics and Gynecology, Universita degli Studi di Milano, Milan, Italia
| | - Brenda Contreras
- Department of Obstetrics and Gynecology, Grupo de Investigación en Cuidado Intensivo y Obstetricia (GRICIO), Universidad de Cartagena, Cartagena de Indias, Colombia
| | - Gabriel Vergara
- Clinica Neurocardiovascular, Departamento de Imagen Cardiaca no Invasiva, Cartagena, Colombia
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Coraducci F, Barbarossa A, Coretti F, Belleggia S, Guerra F. Giant aneurysm of the left atrial appendage: a case report. Eur Heart J Case Rep 2024; 8:ytae099. [PMID: 38434214 PMCID: PMC10908382 DOI: 10.1093/ehjcr/ytae099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 02/11/2024] [Accepted: 02/15/2024] [Indexed: 03/05/2024]
Abstract
Background Left atrial appendage aneurysm (LAAA) is a rare condition mostly due to congenital malformations or secondary causes (i.e. mitral regurgitation). Case summary We present a case of a 47-year-old male with a history of atrial fibrillation treated with propafenone presented to our emergency department for palpitation and epigastric pain. The electrocardiogram showed atrial fibrillation at high ventricular rate and a new-onset left bundle branch block. Urgent coronary angiogram excluded coronary artery disease. Echocardiography and cardiac magnetic resonance revealed a giant LAAA. The electrocardiogram alterations were deemed secondary to aberrancy and treatment with class IC antiarrhythmic. The patient was discussed in the heart team, and considering his will to avoid surgery, he was managed conservatively with closed follow-up, anticoagulant and antiarrhythmic therapy, and internal loop recorder. At 1-year follow-up, he showed asymptomatic and without arrhythmias. Discussion Few cases are described in the literature; therefore, there is uncertainty in treatment and prognosis. Diagnosis is achieved with multimodality imaging. Treatment can be surgical with aneurysmectomy or conservative with regular follow-up by imaging examinations and pharmacological therapy aimed to prevent complications such as thrombosis and arrhythmias. Since high-quality scientific data are lacking, shared decision-making is essential for the management of patients affected by LAAA. In our clinical case, our patient's will to not undergo surgery was considered, and therefore, a conservative management with strict follow-up and medications was chosen.
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Affiliation(s)
- Francesca Coraducci
- Cardiology and Arrhythmology Clinic, Marche Polytechnic University, Marche University Hospital, Via Conca 71, Ancona 60126, Italy
| | - Alessandro Barbarossa
- Cardiology and Arrhythmology Clinic, Marche Polytechnic University, Marche University Hospital, Via Conca 71, Ancona 60126, Italy
| | - Francesca Coretti
- Cardiology and Arrhythmology Clinic, Marche Polytechnic University, Marche University Hospital, Via Conca 71, Ancona 60126, Italy
| | - Sara Belleggia
- Cardiology and Arrhythmology Clinic, Marche Polytechnic University, Marche University Hospital, Via Conca 71, Ancona 60126, Italy
| | - Federico Guerra
- Cardiology and Arrhythmology Clinic, Marche Polytechnic University, Marche University Hospital, Via Conca 71, Ancona 60126, Italy
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3
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Ayala Torres JD, Sepulveda Gallego JA, Gonzalez Gonzalez M. Left Atrial Appendage Aneurysm: A Case Report and Literature Review. Cureus 2024; 16:e56280. [PMID: 38623095 PMCID: PMC11018009 DOI: 10.7759/cureus.56280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2024] [Indexed: 04/17/2024] Open
Abstract
The left atrial appendage aneurysm is an uncommon condition that has garnered attention from the medical community due to its low incidence and varied clinical manifestations. The difficulty in identification is reflected in its incidental detection in imaging studies such as echocardiograms and tomographies, while symptoms range from mild to severe, including heart failure and thromboembolic events. The complex etiology includes congenital and acquired factors, and its management focuses on preventing complications through surgical resection, accompanied by medical strategies such as controlling heart rhythm and anticoagulation. The case of a 67-year-old woman with significant medical history illustrates these challenges. Despite an inconclusive initial diagnosis, a tomography revealed an aneurysm with an intracavitary thrombus, leading to successful surgical resection. However, subsequent infectious complications resulted in her death. The average age of diagnosis is around 30 years, and while it is more common in women, there are no significant gender differences. Surgical management remains the preferred option, especially in severe cases, although in some patients, a watchful waiting approach is chosen. In conclusion, the left atrial appendage aneurysm is a complex entity that requires a multidisciplinary approach to improve clinical outcomes. Early diagnosis and appropriate treatment are crucial to prevent serious complications and improve the quality of life of affected patients.
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Chan YJ, Ly Ly NT, Hai NM, Jan SL. Case Report: One heart with two lobes: a rare infantile congenital giant left atrial appendage aneurysm. Front Pediatr 2023; 11:1302182. [PMID: 38054189 PMCID: PMC10694266 DOI: 10.3389/fped.2023.1302182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 11/02/2023] [Indexed: 12/07/2023] Open
Abstract
Left atrial appendage aneurysm (LAAA) is an extremely rare congenital heart abnormality, with varying degrees of symptoms, ranging from asymptomatic to arrhythmia, thromboembolic event or airway obstruction. Most infantile cases were incidentally found by echocardiography. Contrast-enhanced chest tomography can confirm the diagnosis and inform surgical plan. We describe an asymptomatic young female infant who had a unique extreme cardiomegaly on a chest x-ray and received surgical aneurysmectomy. Her heart was restored to a normal cardiac size after the heart surgery.
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Affiliation(s)
- Yu-Jen Chan
- Department of Pediatrics, Da Chien Hospital, Miaoli, Taiwan
| | - Nguyen Thi Ly Ly
- Division of PediatricCardiology, Dong Nai Children’s Hospital, Bien Hoa, Vietnam
| | - Nguyen Minh Hai
- Division of Pediatric Cardiology, Nhi Dong No1 Hospital, Ho Chi Minh, Vietnam
| | - Sheng-Ling Jan
- Division of Pediatric Cardiology, Children’s Medical Center, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Department of Pediatrics, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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5
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Aksu T, Mutluer FO, Cabbar AT, Huang HD. A giant left atrial appendage aneurysm with left atrial flutter: feasibility of catheter ablation strategy. J Interv Card Electrophysiol 2023; 66:1765-1768. [PMID: 37599320 DOI: 10.1007/s10840-023-01622-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 08/09/2023] [Indexed: 08/22/2023]
Affiliation(s)
- Tolga Aksu
- Department of Cardiology, Yeditepe University Hospital, 34100, Istanbul, Turkey.
| | - Ferit Onur Mutluer
- Department of Cardiology, Yeditepe University Hospital, 34100, Istanbul, Turkey
| | - Ayca Turer Cabbar
- Department of Cardiology, Yeditepe University Hospital, 34100, Istanbul, Turkey
| | - Henry D Huang
- Department of Cardiology, Rush Medical College, Chicago, IL, USA
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6
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Oztunc F, Murt NU, Dedeoglu R, Karagozlu F, Madazli R. Perinatal Outcomes of Fetuses with Prenatally Diagnosed Atrial Appendage Aneurysm. Pediatr Cardiol 2023:10.1007/s00246-023-03286-8. [PMID: 37665339 DOI: 10.1007/s00246-023-03286-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/21/2023] [Indexed: 09/05/2023]
Abstract
To evaluate the characteristics and outcomes of fetuses with atrial appendage aneurysm (AAA) diagnosed by fetal echocardiography. The fetal echocardiography records of 1956 fetuses were evaluated retrospectively. Nine pregnancies who had been diagnosed with fetal AAA prenatally and evaluated after delivery were enrolled in the study. Perinatal and obstetric outcomes were analyzed. The incidence of fetal AAA in our series was 0.46%. Seven fetuses (77.8%) had right AAA, 1 fetus had left AAA (11.1%) and 1 fetus (11.1%) had bilateral AAA. The average gestational age at the first observation and/or diagnosis and gestational age at delivery was 22.3 ± 1.9 weeks and 34.7 ± 4.9 weeks, respectively. Incidences of associated cardiac anomaly, pericardial effusion, and nonimmune hydrops fetalis (NIHF) were 44.4%, 22.2%, and 11.1%, respectively. There was no chromosomal abnormality detected in 4 pregnancies where karyotype analysis was performed. There were 2 neonatal (22.2%) and 1 fetal (11.1%) deaths in our study group. Detailed cardiac and structural ultrasonographic examination should be performed in pregnancies with fetal AAA.
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Affiliation(s)
- Funda Oztunc
- Department of Pediatric Cardiology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Nujin Ulug Murt
- Department of Pediatric Cardiology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Reyhan Dedeoglu
- Department of Pediatric Cardiology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Fatih Karagozlu
- Department of Pediatric Cardiology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Riza Madazli
- Department of Obstetrics and Gynecology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
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7
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Norozi K, Subasri M, Diaz LA, Honjo O. Left atrial appendage aneurysm in pediatrics: Case study and literature review. Front Cardiovasc Med 2023; 10:1211619. [PMID: 37636313 PMCID: PMC10449248 DOI: 10.3389/fcvm.2023.1211619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/28/2023] [Indexed: 08/29/2023] Open
Abstract
Left atrial appendage aneurysm (LAAA) is a rare cardiac pathology that is often identified in adulthood. There are a myriad of presentations related to atrial appendage enlargement, but most are asymptomatic. Pediatric cases of LAAA are extremely rare. We report a case of an incidental giant LAAA found in a healthy 6-year-old boy. He was successfully treated with surgical resection. A review of the literature shows that the presentation of LAAA in pediatrics likely involves cardiac or respiratory symptoms but can also be incidental findings. Similar to adults, diagnosis requires cardiac imaging, with echocardiography being the mainstay. Surgical intervention is indicated in symptomatic and most asymptomatic patients to prevent complications. More research is warranted into the optimal timing of surgery and alternative surgical approaches for complex cases.
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Affiliation(s)
- Kambiz Norozi
- Department of Paediatrics, University of Western Ontario, London, ON, Canada
- Division of Pediatric Cardiology, Department of Paediatrics, London Health Sciences Centre, London, ON, Canada
- Pediatric Cardiopulmonary Research Laboratory, London Health Sciences Centre, London, ON, Canada
- Children Health Research Institute, London, ON, Canada
- Department of Paediatric Cardiology, Medical School Hannover, Hannover, Germany
| | - Mathushan Subasri
- Division of Pediatric Cardiology, Department of Paediatrics, London Health Sciences Centre, London, ON, Canada
- Pediatric Cardiopulmonary Research Laboratory, London Health Sciences Centre, London, ON, Canada
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Luis Altamirano Diaz
- Department of Paediatrics, University of Western Ontario, London, ON, Canada
- Division of Pediatric Cardiology, Department of Paediatrics, London Health Sciences Centre, London, ON, Canada
- Pediatric Cardiopulmonary Research Laboratory, London Health Sciences Centre, London, ON, Canada
- Children Health Research Institute, London, ON, Canada
| | - Osami Honjo
- Department of Surgery, The Hospital for Sick Children, Toronto, ON, Canada
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Atasayan V, Sarı YE, Öner T. Left atrial appendage aneurysm in newborns: a report of two cases. Cardiol Young 2023; 33:1477-1478. [PMID: 36647710 DOI: 10.1017/s1047951123000069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Left atrial appendage aneurysm is an extremely rare cardiac anomaly with serious complications. It is rarely diagnosed in childhood. Herein, we reported two newborns diagnosed with left atrial appendage aneurysm.
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Affiliation(s)
- Vildan Atasayan
- Department of Pediatric Cardiology, University of Health Sciences, Umraniye Training and Research Hospital, İstanbul, Turkey
| | - Yunus Emre Sarı
- Department of Pediatric Cardiology, University of Health Sciences, Umraniye Training and Research Hospital, İstanbul, Turkey
| | - Taliha Öner
- Department of Pediatric Cardiology, University of Health Sciences, Umraniye Training and Research Hospital, İstanbul, Turkey
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9
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Rhee DW, Aizer A, Chinitz LA, Saric M, Vainrib AF. The Double-Orifice Left Atrial Appendage: Multimodality and Virtual Transillumination Imaging. CASE (PHILADELPHIA, PA.) 2023; 7:335-337. [PMID: 37614689 PMCID: PMC10442454 DOI: 10.1016/j.case.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
•LAA membranes are exceedingly rare with variable morphologies. •Thromboembolic risk with LAA membranes remains unknown. •Use of 3D TEE transillumination may assist in visualization and understanding.
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Affiliation(s)
- David W. Rhee
- Leon H. Charney Division of Cardiology, NYU Langone Health, New York, New York
| | - Anthony Aizer
- Leon H. Charney Division of Cardiology, NYU Langone Health, New York, New York
| | - Larry A. Chinitz
- Leon H. Charney Division of Cardiology, NYU Langone Health, New York, New York
| | - Muhamed Saric
- Leon H. Charney Division of Cardiology, NYU Langone Health, New York, New York
| | - Alan F. Vainrib
- Leon H. Charney Division of Cardiology, NYU Langone Health, New York, New York
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10
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Xiong J, Wenbo Y, Gao J, Li M, Yu D. Radiofrequency ablation-induced superior vena cava stenosis in a 5-year-old boy with congenital left atrial appendage deformity: a case report and literature review. Front Surg 2023; 10:1199335. [PMID: 37492621 PMCID: PMC10365907 DOI: 10.3389/fsurg.2023.1199335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/21/2023] [Indexed: 07/27/2023] Open
Abstract
Superior vena cava (SVC) stenosis is rarely caused by iatrogenic trauma. Herein, the case of a 5-year-old boy who underwent radiofrequency ablation for paroxysmal supraventricular tachycardia but developed SVC stenosis and related syndromes is reported. Notably, the child exhibited an enlarged left atrial appendage that had partially breached the pericardium. Subsequent interventions involved successful removal of the stenosis, artificial vascular reconstruction, and comprehensive radiofrequency ablation of the entire right atrium, along with ligation of the left atrial appendage under direct vision. As a result, the child experienced relief from symptoms.
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Affiliation(s)
- Jianxian Xiong
- Department of Cardiovascular Surgery, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Yu Wenbo
- The First Clinical Medical College, Gannan Medical University, Ganzhou, China
| | - Jianfeng Gao
- The First Clinical Medical College, Gannan Medical University, Ganzhou, China
| | - Meifang Li
- Department of Breast Disease Comprehensive Center, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Dongmin Yu
- Department of Breast Disease Comprehensive Center, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
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11
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Penfold MP, Haq IU, Connolly HM, Dearani JA, Schaff HV, Miranda WR, Asirvatham SJ, Killu AM, Arghami A, Stephens EH. Atrial Appendage Aneurysms: Natural History and Outcomes. World J Pediatr Congenit Heart Surg 2023; 14:474-480. [PMID: 36972504 DOI: 10.1177/21501351231162909] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
BACKGROUND Left (LAAA) and right atrial appendage aneurysms (RAAA) are rare entities, and their natural history, management, and long-term outcomes are not well studied. METHODS This retrospective review includes all patients from 2000 to 2021 with atrial appendage aneurysms at our institution identified using an electronic search tool. LAAA and RAAA were confirmed using multimodality imaging and intraoperative findings. RESULTS We identified 13 (87%) patients with LAAA and 2 (13%) with RAAA. At diagnosis, 11 (73%) were female, mean age was 51.4 ± 18.8 years, and ejection fraction 56.5 ± 13.1%. Three (20%) patients had congenital heart disease including 2 (13%) with atrioventricular septal defects and 1 (7%) with congenitally corrected transposition. LAAA/RAAA was diagnosed due to new-onset atrial fibrillation (AF) in 6 (40%) patients and embolic stroke in 2 (13%). Ten patients had preexisting AF diagnosed 2.9 ± 1.4 years earlier at a mean age of 50.2 ± 15.5 years. Thrombus within the aneurysm was identified in 2 (15%) LAAA patients. All patients were on anticoagulation and follow-up of the cohort from diagnosis was 7.1 ± 6.2 years. Eleven (73%) patients were surgically managed with 7 (64%) lesions excised, 1 (9%) stapled, and 3 (27%) ligated. Postoperative complications occurred in 2 (18%) patients with 1 (7%) developing tricuspid regurgitation and another with pericardial effusion and tamponade. CONCLUSIONS Atrial appendage aneurysm is a rare disease and nearly half of patients present with AF. Surgical treatment with concomitant AF ablation is a reasonable and safe management option.
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Affiliation(s)
| | - Ikram-Ul Haq
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Heidi M Connolly
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Joseph A Dearani
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, USA
| | - Hartzell V Schaff
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, USA
| | | | - Samuel J Asirvatham
- Department of Pediatrics, Mayo Clinic, Rochester, MN, USA
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Ammar M Killu
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Arman Arghami
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, USA
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12
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Cheng H, Sandeep B, Fang Z, Xiao Z. Giant left atrial aneurysm with normal left atrial appendage: A case report. Asian J Surg 2023:S1015-9584(23)00357-3. [PMID: 36990816 DOI: 10.1016/j.asjsur.2023.03.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 03/09/2023] [Indexed: 03/28/2023] Open
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13
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Minimally invasive resection of a giant left atrial appendage aneurysm. JTCVS Tech 2022; 16:219-222. [PMID: 36510538 PMCID: PMC9737027 DOI: 10.1016/j.xjtc.2022.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/28/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022] Open
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Freire M, Conversy B, De Lasalle J, Fontaine P, Rousseau‐Blass F, Pang DSJ. Surgical correction of left auricular aneurysm herniation through a pericardial defect in a dog with atrial fibrillation and mitral valve disease. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Mila Freire
- Faculty of Veterinary Medicine Université de Montréal St‐Hyacinthe Québec Canada
| | - Bérénice Conversy
- Faculty of Veterinary Medicine Université de Montréal St‐Hyacinthe Québec Canada
| | | | | | | | - Daniel S. J. Pang
- Faculty of Veterinary Medicine Université de Montréal St‐Hyacinthe Québec Canada
- Faculty of Veterinary Medicine University of Calgary Calgary Alberta Canada
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15
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Li R, Ma F, Guan HX, Pan YY, Liu LG, Wang DW, Wang H. Case Report: Giant Congenital Left Atrial Appendage Aneurysm Presenting With Acute Massive Cerebral Infarction and Refractory Atrial Fibrillation: A Case Report and Literature Review. Front Cardiovasc Med 2022; 9:888825. [PMID: 35620516 PMCID: PMC9127081 DOI: 10.3389/fcvm.2022.888825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 04/11/2022] [Indexed: 12/10/2022] Open
Abstract
Background Congenital left atrial appendage aneurysm (LAAA) is a rare cardiac anomaly with a variety of presentations, from being asymptomatic to potentially serious complications such as systemic thromboembolism and atrial tachyarrhythmia. Case Presentation We report a case of congenital giant LAAA in a 35-year-old man presenting with acute massive cerebral infarction and atrial fibrillation (AF) with rapid ventricular rate. The AF was refractory to conventional antiarrhythmic agents, such as amiodarone and electrical cardioversion, but restored and maintained sinus rhythm after surgical resection of LAAA. The patient remained free of events and was in sinus rhythm during half-year follow-up. Conclusion Giant LAAA has the potential causing serious complications and should be managed surgically in most cases.
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Affiliation(s)
- Rui Li
- Division of Cardiology, Department of Internal Medicine, Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiologic Disorders, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fei Ma
- Division of Cardiology, Department of Internal Medicine, Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiologic Disorders, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Han Xiong Guan
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yue Ying Pan
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Gang Liu
- Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dao Wen Wang
- Division of Cardiology, Department of Internal Medicine, Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiologic Disorders, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hong Wang
- Division of Cardiology, Department of Internal Medicine, Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiologic Disorders, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Hong Wang,
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16
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Kissami I, El Ouazzani G, El Bekkaoui M, Skiker I, Elouafi N, Bazid Z. Giant aneurysm of the left atrial appendage: A case report of a rare cause of dyspnea in a 55-year old woman. Ann Med Surg (Lond) 2021; 71:102905. [PMID: 34703581 PMCID: PMC8521123 DOI: 10.1016/j.amsu.2021.102905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 12/01/2022] Open
Abstract
Introduction Congenital aneurysm of the left atrial appendage (LAAA) is a very rare heart with potentially serious and life-threatening complications. Diagnosis is difficult because of the asymptomatic forms, until complications arise. Early surgery is the treatment of choice, but the recommendation today remains unclear. Case report We present a case of congenital giant left atrial appendage aneurysm (LAAA), in a 55-year-old, woman, without any medical or surgical history, who presented with dyspnea, in whom transthoracic echocardiograhpy demonstrated the presence of a giant left atrial aneurysm with thickening of the small mitral valve, a chest scan confirmed the diagnosis of LAAA and a myocardial magnetic resonance imaging revealed the presence of thickened mitral valve with bi-valvular balloonization and annular disjunction, thickening of the basal segments of the inferior and lateral wall, left atrial aneurysm with a dilated right coronary artery. Coronary angiography showed a tortuous coronary artery with a loop in the second segment without any significant stenosis. The patient is currently awaiting surgery. Conclusion Left atrial appendage aneurysm is a serious illness will likely require years of medical care and follow up in the absence of surgical treatment. The choice and timing of surgical, conservative or catheter treatment always remains a challenge. Our case report shows that medical treatment is a safe approach that will delay or avoid surgery. Left atrial appendage aneurysm is extremely rare. Asymptomatic, congenital or acquired. The prognosis depends greatly on early diagnosis and prompt medical and surgical treatment. The diagnosis is a real challenge.
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Affiliation(s)
- Ibtissam Kissami
- Department of Cardiology, Mohamed First University, Faculty of Medicine and Pharmacy, Oujda, Morocco
| | - Ghizlane El Ouazzani
- Department of Cardiology, Mohamed First University, Faculty of Medicine and Pharmacy, Oujda, Morocco
| | - Mehdi El Bekkaoui
- Department of Radiology, Mohamed First University, Faculty of Medicine and Pharmacy, Oujda, Morocco
| | - Imane Skiker
- Department of Radiology, Mohamed First University, Faculty of Medicine and Pharmacy, Oujda, Morocco
| | - Nouha Elouafi
- Department of Cardiology, Mohamed First University, Faculty of Medicine and Pharmacy, Oujda, Morocco
| | - Zakaria Bazid
- Department of Cardiology, Mohamed First University, Faculty of Medicine and Pharmacy, Oujda, Morocco.,Laboratory of Epidemiology and Clinical Research, Faculty of Medicine and Pharmacy, Oujda, Morocco
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17
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Sasaki T, Kawasaki Y, Murakami Y, Fujino M, Nakamura K, Yoshida Y, Suzuki T, Nishigaki K, Ehara E. Prenatally diagnosed left atrial appendage aneurysm with various postnatal imaging investigations: A case report. Echocardiography 2021; 38:1809-1812. [PMID: 34510535 DOI: 10.1111/echo.15192] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/26/2021] [Accepted: 08/20/2021] [Indexed: 11/28/2022] Open
Abstract
A congenital left atrial appendage aneurysm (LAAA) is a rare cardiac malformation, that is, usually diagnosed in adulthood. It is rarely diagnosed prenatally. In most cases, surgical resection is recommended soon after the diagnosis has been made due to the risk of arrhythmia and thrombotic events. The present report describes a case of LAAA that was prenatally diagnosed and was asymptomatic postnatally. Imaging revealed the relation of the cardiac and airway structures around the LAAA in detail. The patient underwent surgical resection of the LAAA successfully at 7 months of age and is currently healthy at 5 years of age.
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Affiliation(s)
- Takeshi Sasaki
- Department of Pediatric Cardiology, Osaka City General Hospital, Osaka, Japan
| | - Yuki Kawasaki
- Department of Pediatric Cardiology, Osaka City General Hospital, Osaka, Japan
| | - Yosuke Murakami
- Department of Pediatric Cardiology, Osaka City General Hospital, Osaka, Japan
| | - Mitsuhiro Fujino
- Department of Pediatric Cardiology, Osaka City General Hospital, Osaka, Japan
| | - Kae Nakamura
- Department of Pediatric Cardiology, Osaka City General Hospital, Osaka, Japan
| | - Yoko Yoshida
- Department of Pediatric Arrhythmia, Osaka City General Hospital, Osaka, Japan
| | - Tsugutoshi Suzuki
- Department of Pediatric Arrhythmia, Osaka City General Hospital, Osaka, Japan
| | - Kyoichi Nishigaki
- Department of Pediatric Cardiovascular Surgery, Osaka City General Hospital, Osaka, Japan
| | - Eiji Ehara
- Department of Pediatric Cardiology, Osaka City General Hospital, Osaka, Japan
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18
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Yanli Z, Xiaocong W, Liping P, Yan M, Wei Y, Shu J. Diagnosis of a giant left atrial appendage aneurysm by contrast-enhanced echocardiography: Case report and literature review. JOURNAL OF CLINICAL ULTRASOUND : JCU 2021; 49:293-297. [PMID: 33301199 DOI: 10.1002/jcu.22962] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 09/16/2020] [Accepted: 11/03/2020] [Indexed: 06/12/2023]
Abstract
Left atrial appendage aneurysm (LAAA) is a rare pathologic entity that can be congenital or, more frequently, acquired. Its complications include arrhythmias and thromboembolic events, palpitations, hiccups, chest pain, dyspnea, and myocardial infarction. LAAA can be isolated or associated with other congenital anomalies such as atrial septal defect, ventricular septal defect, anomalous renal artery, Noonan syndrome, and Hurler-Scheie syndrome. We report a rare case of giant LAA with intra-aneurysmal thrombus diagnosed by contrast-enhanced echocardiography.
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Affiliation(s)
- Zhang Yanli
- Department of Echocardiography, The First hospital of Jilin University, Changchun, China
| | - Wang Xiaocong
- Department of Echocardiography, The First hospital of Jilin University, Changchun, China
| | - Pei Liping
- Department of Echocardiography, The First hospital of Jilin University, Changchun, China
| | - Ma Yan
- Department of Echocardiography, The First hospital of Jilin University, Changchun, China
| | - Yu Wei
- Department of Echocardiography, The First hospital of Jilin University, Changchun, China
| | - Jiang Shu
- Department of Echocardiography, The First hospital of Jilin University, Changchun, China
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19
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Safe treatment of congenital left atrial appendage aneurysm using lateral thoracotomy on a 3-year-old patient. Cardiol Young 2021; 31:144-147. [PMID: 33526162 DOI: 10.1017/s1047951120003248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Limited literatures report the management of congenital left atrial appendage aneurysm (LAAA) which is extremely rare. Chest X-ray firstly showed an enlarged left cardiac silhouette for a 3-year-old patient with pneumonia. Echocardiography and magnetic resonance imaging confirmed a large cyst attached to the left atrium. Aneurysmectomy was performed through lateral thoracotomy using step-by-step method and under the guidance of transoesophageal echocardiography. We aim to show the safety and efficacy of this approach applied to children associated with congenital LAAA.
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20
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Belov DV, Moskalev VI, Garbuzenko DV, Arefyev NO. Left atrial appendage aneurysm: A case report. World J Clin Cases 2020; 8:4443-4449. [PMID: 33083403 PMCID: PMC7559682 DOI: 10.12998/wjcc.v8.i19.4443] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 06/08/2020] [Accepted: 09/09/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND An aneurysm of the left atrial appendage is one of the rare but potentially hazardous heart defects. The risk of lethal complications grows with its size. To date, about 150 cases of this defect have been described in the literature. We present a case of left atrial appendage aneurysm with the deformation of the mitral valve and the left main coronary and circumflex artery, which required mitral valve annuloplasty and bifurcation stenting.
CASE SUMMARY A 58-year-old man presented to our hospital complaining of shortness of breath, general weakness, dizziness during physical exertion, and fatigue. Based on the results of echocardiography, an aneurysm of the left atrium was suspected. A free-breathing real-time cine magnetic resonance imaging with electrocardiograph synchronization confirmed the diagnosis of left atrial appendage aneurysm. The patient underwent an aneurysmectomy via a median sternotomy with cardiopulmonary bypass. Intraoperative transesophageal echocardiography revealed relative mitral insufficiency that was corrected with an annuloplasty ring. Intraoperative coronary angiogram showed impaired blood flow in the left main coronary and circumflex artery and 60% stenosis. For this reason, bifurcation stenting was performed. The patient had an uneventful postoperative clinical course and was discharged from the hospital on the 10th day in a satisfactory condition.
CONCLUSION Left atrial appendage aneurysm is a rare and dangerous heart pathology that requires surgery to prevent related complications.
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Affiliation(s)
- Dmitry Vladimirovich Belov
- Department of Hospital Surgery, South Ural State Medical University, Chelyabinsk 454092, Russia
- Department of Hospital Surgery, Federal Center for Cardiovascular Surgery, Chelyabinsk 454033, Russia
| | | | | | - Nikolay Olegovich Arefyev
- Department of Pathological Anatomy and Forensic Medicine, South Ural State Medical University, Chelyabinsk 454092, Russia
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21
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Kothandam S, Ramasamy R. Planning and execution of catheter closure of a giant left atrial appendage aneurysm causing recurrent cardioembolism. Ann Pediatr Cardiol 2020; 13:353-356. [PMID: 33311928 PMCID: PMC7727907 DOI: 10.4103/apc.apc_76_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 06/27/2020] [Accepted: 07/27/2020] [Indexed: 01/22/2023] Open
Abstract
Giant left atrial appendage aneurysms (LAAAs) are rare causes of recurrent cardioembolism and managed routinely by surgery. A first catheter closure of a giant LAAA is reported, when a recent cerebral infarct precluded immediate surgery. Planning included ostial measurement on multimodal imaging, echo navigation for septal puncture, rotational angiogram for profiling, overlay imaging for device placement, and cerebral embolic protection from thrombus debris.
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Affiliation(s)
- Sivakumar Kothandam
- Department of Pediatric Cardiology, Madras Medical Mission, Chennai, Tamil Nadu, India
| | - Rajeshkumar Ramasamy
- Department of Pediatric Cardiology, Madras Medical Mission, Chennai, Tamil Nadu, India
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22
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Fakhri G, Obeid M, El Rassi I, Tabbakh A, Bitar F, Alameddine M, Arabi M. Large congenital left atrial wall aneurysm: An updated and comprehensive review of the literature. Echocardiography 2020; 37:965-970. [PMID: 32428351 DOI: 10.1111/echo.14687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/29/2020] [Accepted: 04/21/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Congenital left atrial wall aneurysms are rare abnormalities that arise from a developmental weakness in the muscular wall. It may be misdiagnosed or go undetected and the delay in diagnosis can lead to catastrophic consequences. CASE PRESENTATION An updated and comprehensive review of the literature was performed for all patients with this abnormality under the age of 18. A total of 15 cases including ours are presented in this article. We present a 10-month-old boy who was referred to our center for cardiomegaly. Workup revealed a large atrial wall aneurysm that was successfully corrected with surgery. CONCLUSION Historically, left atrial aneurysms were uncommon in the absence of valvular heart disease or other cardiac conditions. Congenital aneurysms are rare phenomenon because they arise without an acquired cardiac disease and surgical correction is crucial for survival.
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Affiliation(s)
- Ghina Fakhri
- Division of Cardiology, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mounir Obeid
- Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Issam El Rassi
- Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Anas Tabbakh
- Division of Cardiology, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Fadi Bitar
- Division of Cardiology, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mona Alameddine
- Division of Cardiology, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mariam Arabi
- Division of Cardiology, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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23
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Barac YD, Quinones Q, Schroder J, Glower DD. Congenital left atrial appendage pseudoaneurysm, cardiomyopathy, and mitral regurgitation. Ann Pediatr Cardiol 2020; 13:107-108. [PMID: 32030053 PMCID: PMC6979037 DOI: 10.4103/apc.apc_10_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 03/18/2019] [Accepted: 04/03/2019] [Indexed: 11/05/2022] Open
Affiliation(s)
- Yaron D Barac
- The Division of Cardiovascular and Thoracic Surgery, Duke University Medical Center, Durham, NC, USA E-mail:
| | - Quintin Quinones
- The Division of Cardiovascular and Thoracic Surgery, Duke University Medical Center, Durham, NC, USA E-mail:
| | - Jacob Schroder
- The Division of Cardiovascular and Thoracic Surgery, Duke University Medical Center, Durham, NC, USA E-mail:
| | - Donald D Glower
- The Division of Cardiovascular and Thoracic Surgery, Duke University Medical Center, Durham, NC, USA E-mail:
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24
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G B, Vedula K, Aggarwal P. Young Female With Palpitations. Ann Emerg Med 2019; 74:303-304. [PMID: 31331497 DOI: 10.1016/j.annemergmed.2019.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Bharath G
- Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Kartik Vedula
- Department of Infectious Disease, All India Institute of Medical Sciences, New Delhi, India
| | - Praveen Aggarwal
- Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India
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25
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Tandon R, Arisha MJ, Nanda NC, Kumar S, Wander GS, Srialluri S, Kamel H, Salama AY. Incremental benefit of three-dimensional transthoracic echocardiography in the assessment of left atrial appendage aneurysm leading to severe extrinsic compression of a coronary artery. Echocardiography 2018; 35:685-691. [DOI: 10.1111/echo.13901] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Rohit Tandon
- Hero Dayanand Medical College and Hospital; Ludhiana Punjab India
| | - Mohammed J. Arisha
- Division of Cardiovascular Disease; University of Alabama at Birmingham; Birmingham AL USA
| | - Navin C. Nanda
- Division of Cardiovascular Disease; University of Alabama at Birmingham; Birmingham AL USA
| | - Sooraj Kumar
- Hero Dayanand Medical College and Hospital; Ludhiana Punjab India
| | | | - Swetha Srialluri
- Division of Cardiovascular Disease; University of Alabama at Birmingham; Birmingham AL USA
| | - Hassan Kamel
- Division of Cardiovascular Disease; University of Alabama at Birmingham; Birmingham AL USA
| | - Ahmed Y. Salama
- Division of Cardiovascular Disease; University of Alabama at Birmingham; Birmingham AL USA
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26
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Aydin Sahin D, Vefa Yildirim S, Ozkan M. A rare giant congenital left atrial appendage aneurysm in a 1-day-old newborn. Echocardiography 2018; 35:757-759. [PMID: 29648705 DOI: 10.1111/echo.13883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Congenital left atrial appendage aneurysm (LAAA) is a very rare condition and occurs as a result of congenital dysplasia of musculi pectinate. These patients may be asymptomatic and/or may present with dyspnea, and thromboembolic events. The most common complications are life-threatening thromboembolic events and supraventricular tachyarrhythmias. Transthoracic echocardiography plays a very important role in the diagnosis of LAAA. Herein, we present a rare case of giant congenital LAAA.
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Affiliation(s)
- Derya Aydin Sahin
- Department of Pediatric Cardiology, Mersin City Hospital, Mersin, Turkey
| | - Selman Vefa Yildirim
- Pediatric Cardiology Division, Pediatrics Department, Near East University, Nicosia, Cyprus
| | - Murat Ozkan
- Cardiovascular Surgery Department, Baskent University, Ankara, Turkey
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27
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Abstract
This is a case of both congenital left ventricular (LV) free wall submitral aneurysm and left atrial appendage aneurysm with 6 years of clinical follow-up. Each lesion is a rare entity, and to the best of our knowledge, this is the first case in medical literature of both lesions occurring in the same patient, raising the likelihood of a common etiology. The workup was initiated in the third trimester of fetal life with irregular heart rate and abnormal fetal ultrasound and echocardiogram at that time. The patient required emergent atrial appendage plication due to blood clot formation and suffered from multiple other complications including ventricular ectopy and surgically induced pseudoaneurysm. Follow-up interval echocardiograms have revealed continued good LV function with persistent LV aneurysm. In review of the case, there were several potential in utero causes including maternal viral upper respiratory infection and bacteriuria with exposure to amoxicillin. These as well as other considerations are discussed along with a brief review of these rare lesions, usual presentation, and known associations.
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Affiliation(s)
- Ryan F Halas
- Department of Internal Medicine-Pediatrics, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - Christopher J Schmehil
- Department of Pediatrics, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - Gary R Ten Eyck
- Department of Biomedical Sciences, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - James L Loker
- Department of Pediatric Cardiology, Bronson Children's Hospital, Kalamazoo, MI, USA
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28
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Dye L, Freed JK, Leschke JR, Pagel PS. A Rare Cause of Intermittent Dyspnea, Occasional Palpitations, and Atypical Chest Discomfort. J Cardiothorac Vasc Anesth 2017; 32:2031-2033. [PMID: 29196139 DOI: 10.1053/j.jvca.2017.10.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Lonnie Dye
- Department of Anesthesiology, the Medical College of Wisconsin, Milwaukee, WI
| | - Julie K Freed
- Department of Anesthesiology, the Medical College of Wisconsin, Milwaukee, WI
| | - Joseph R Leschke
- Department of Anesthesiology, the Medical College of Wisconsin, Milwaukee, WI
| | - Paul S Pagel
- Anesthesia Service, the Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, WI.
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29
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Morin J, Cantin L, Pasian S, Philippon F, Beaudoin J. Giant Left Atrial Appendage Aneurysm Mimicking Mediastinal Mass and Associated with Incessant Atrial Arrhythmias. J Atr Fibrillation 2017; 9:1539. [PMID: 29250290 DOI: 10.4022/jafib.1539] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 02/19/2017] [Accepted: 03/14/2017] [Indexed: 11/10/2022]
Abstract
Left atrial appendage aneurysm (LAAA) is a rare entity. Clinical manifestations include arrhythmias and systemic embolization. We show here an example of a large and ectopic LAAA mimicking a mediastinal mass on chest X-ray and presenting with incessant atrial arrhythmias. Subsequent investigations leading to the correct diagnosis are described.
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Affiliation(s)
- Joëlle Morin
- Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, Canada
| | - Luce Cantin
- Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, Canada
| | - Sergio Pasian
- Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, Canada
| | - François Philippon
- Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, Canada
| | - Jonathan Beaudoin
- Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, Canada
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30
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Chen Y, Mou Y, Jiang LJ, Hu SJ. Congenital giant left atrial appendage aneurysm: a case report. J Cardiothorac Surg 2017; 12:15. [PMID: 28302138 PMCID: PMC5356375 DOI: 10.1186/s13019-017-0576-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 02/21/2017] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Congenital left atrial appendage aneurysm (LAAA) is a rare cardiac anomaly with potentially serious complications, including life-threatening systemic thromboembolism, atrial tachyarrhythmia, and cardiac dysfunction. Currently, early surgical intervention is generally recommended to prevent these complications. CASE PRESENTATION We present a case of congenital giant LAAA in a female patient who successfully completed pregnancy and underwent caesarean section with no obvious complications. Surgical resection of the LAAA was performed 3 years later, at the onset of chest pain resulting from compression of adjacent cardiac structures by the LAAA. CONCLUSION Surgical resection is recommended for the majority of patients with LAAA because of potential LAAA-related severe outcomes. However, clinical monitoring may be an optional strategy for asymptomatic patients without intra-atrial thrombus or other complications. Precise evaluation with echocardiography and brain magnetic resonance imaging is valuable for the subsequent management of LAAA.
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Affiliation(s)
- Yan Chen
- Echocardiography and Vascular Ultrasound Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Yun Mou
- Echocardiography and Vascular Ultrasound Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Li-Jun Jiang
- Department of Thoracic Cardiovascular Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Shen-Jiang Hu
- Institute of Cardiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, No.79, Qing-Chun Road, Hangzhou, China.
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31
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Valentino MA, Al Danaf J, Morris R, Tecce MA. Giant left atrial appendage aneurysm: A case of mistaken identity. J Cardiol Cases 2017; 15:129-131. [PMID: 30279759 DOI: 10.1016/j.jccase.2016.12.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 11/23/2016] [Accepted: 12/15/2016] [Indexed: 02/08/2023] Open
Abstract
Left atrial appendage (LAA) aneurysm is a rare condition that can be congenital or acquired. Most cases are discovered incidentally. However, the most frequent clinical presentations include supraventricular tachycardias and systemic embolization. Most cases in the literature were treated by resection of the LAA, and it has been recommended to perform LAA resection even in asymptomatic patients in order to prevent thromboembolic events. Here, we describe the safe, conservative management of a patient who was initially felt to have congenital partial absence of the left pericardium but at surgery the diagnosis of LAA aneurysm was established. <Learning objective: LAA aneurysm is a rare condition which has typically been managed with prompt surgical excision due to the perceived high risk of thromboembolic events. Our case demonstrates that LAA aneurysm and its associated arrhythmias can be treated medically with AV-nodal blockade and oral anticoagulation in the asymptomatic patient. Conservative management of asymptomatic patients with a LAA aneurysm with close monitoring of LAA size may allow for a delay or possible avoidance of surgery.>.
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Affiliation(s)
- Michael A Valentino
- Thomas Jefferson University Hospital, Department of Internal Medicine, Division of Cardiology, Philadelphia, PA, USA
| | - Jad Al Danaf
- Thomas Jefferson University Hospital, Department of Internal Medicine, Philadelphia, PA, USA
| | - Rohinton Morris
- Thomas Jefferson University Hospital, Department of Surgery, Division of Cardio-thoracic Surgery, Philadelphia, PA, USA
| | - Marc A Tecce
- Thomas Jefferson University Hospital, Department of Internal Medicine, Division of Cardiology, Philadelphia, PA, USA
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32
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Bamous M, Aithoussa M, Abetti A, Boulahya A. Congenital left atrial appendage aneurysm: Atypical presentation. Ann Pediatr Cardiol 2017; 10:293-294. [PMID: 28928618 PMCID: PMC5594943 DOI: 10.4103/apc.apc_4_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Congenital left atrial appendage aneurysm is a rare condition caused by dysplasia of the atrial muscles. We report a case of a 14-year-old boy, with a 5-month history of cough and in sinus rhythm. Transthoracic echocardiography and computerized tomographic angiography confirmed the aneurysm of the left atrial appendage which was resected through median sternotomy on cardiopulmonary bypass. This case is presented not only for its rarity but also for its atypical clinical presentation.
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Affiliation(s)
- Mehdi Bamous
- Department of Cardiovascular, Cardiac Surgery Unit, Mohamed V Military Hospital, Mohammed V University, Rabat, Morocco
| | - Mahdi Aithoussa
- Department of Cardiovascular, Cardiac Surgery Unit, Mohamed V Military Hospital, Mohammed V University, Rabat, Morocco
| | - Ayoub Abetti
- Department of Cardiovascular, Cardiac Surgery Unit, Mohamed V Military Hospital, Mohammed V University, Rabat, Morocco
| | - Abdelatif Boulahya
- Department of Cardiovascular, Cardiac Surgery Unit, Mohamed V Military Hospital, Mohammed V University, Rabat, Morocco
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33
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Abstract
A congenital aneurysm of the left atrial wall (ALAW) is a rare defect resulting from dysplasia and degeneration of myocardial cells in embryogenesis. We report a case of a 50-year-old female with ALAW, and review 16 previously reported cases and summarize the clinical features, imaging data, and the operations used to treat this rare disease.
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Affiliation(s)
- Yuyan Cai
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Xin Wei
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Hong Tang
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Ke Dian
- Department of Cardiovascular Surgery, West China Hospital of Sichuan University, Chengdu, China
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34
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Wagdy K, Samaan A, Romeih S, Simry W, Afifi A, Hassan M. Giant left atrial appendage aneurysm compressing the left anterior descending coronary artery. Echocardiography 2016; 33:1790-1792. [PMID: 27539326 DOI: 10.1111/echo.13296] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Left atrial appendage aneurysm (LAAA) is a rare congenital structural heart disease. It is often diagnosed by echocardiography; however, other imaging modalities can add to its diagnosis and its potential effects on the surrounding structures. A 16-year-old boy presented with dyspnea and palpitation. Transthoracic echocardiography showed a large LAAA communicating with the LA through a narrow neck with impaired left ventricular (LV) systolic function. Multidetector cardiac tomography showed that the LAAA is compressing the left anterior descending artery. The LAAA was surgically resected followed by improvement of the LV systolic function.
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Affiliation(s)
- Kerolos Wagdy
- Adult Cardiology, Aswan Heart Centre, Magdi Yacoub Foundation, Aswan, Egypt
| | - Amir Samaan
- Adult Cardiology, Aswan Heart Centre, Magdi Yacoub Foundation, Aswan, Egypt.,Cardiovascular Department, Cairo University, Cairo, Egypt
| | - Soha Romeih
- Adult Cardiology, Aswan Heart Centre, Magdi Yacoub Foundation, Aswan, Egypt.,Radiology Department, Aswan Heart Centre, Magdi Yacoub Foundation, Aswan, Egypt
| | - Walid Simry
- Cardiothoracic Department, Aswan Heart Centre, Magdi Yacoub Foundation, Aswan, Egypt
| | - Ahmed Afifi
- Cardiothoracic Department, Aswan Heart Centre, Magdi Yacoub Foundation, Aswan, Egypt
| | - Mohamed Hassan
- Adult Cardiology, Aswan Heart Centre, Magdi Yacoub Foundation, Aswan, Egypt.,Cardiovascular Department, Cairo University, Cairo, Egypt
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35
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Naksuk N, Padmanabhan D, Yogeswaran V, Asirvatham SJ. Left Atrial Appendage. JACC Clin Electrophysiol 2016; 2:403-412. [DOI: 10.1016/j.jacep.2016.06.006] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 05/11/2016] [Accepted: 06/24/2016] [Indexed: 02/08/2023]
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Endoscopic Resection of a Giant Left Atrial Appendage. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2016; 10:282-4. [PMID: 26355691 DOI: 10.1097/imi.0000000000000172] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
A 23-year-old woman with a history of arterial hypertension presented to our institution complaining of dyspnea and chest pain. Her workup including echocardiography and magnetic resonance imaging revealed an aneurysm of the left atrial appendage. No thrombus was identified in the aneurysm or left atrial appendage, and the patient was in sinus rhythm. She was started on prophylactic anticoagulation, and surgical resection of the aneurysm was recommended as a definitive treatment of this lesion. The surgery was performed using a minimally invasive left-sided thoracoscopy approach. The entire left atrial appendage including the aneurysm was removed at its base using an articulating endoscopic stapler device. On postoperative echocardiography, no residual left atrial appendage tissue was evident. The patient could be taken off oral anticoagulation and left the hospital in good condition.
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Karakurt C, Türköz R, Sarıtaş B, Çelik S, Elkıran Ö. Huge Left Atrial Pseudoaneurysm in a 5-Month-Old Baby Presented with Supraventricular Tachycardia. ACTA CARDIOLOGICA SINICA 2016; 32:108-11. [PMID: 27122939 DOI: 10.6515/acs20150514a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
UNLABELLED Cardiac pseudoaneurysm is an extremely rare condition in children. It can be congenital or acquired and has been primarily described in the left side of the heart. The congenital form of pseudoaneurysm is thought to be related to muscular dysplasia of the muscular layer of the heart. The acquired form is related to myocardial infarction, infective endocarditis or chest trauma. In this report we described a 5-month-old baby with left atrial pseudoaneurysm who was referred to our hospital due to tachycardia and hemodynamic instability. After diagnosis of left atrial pseudoaneurysm, aneurysmectomy was performed and the left atrial wall was successfully repaired by surgery three days after admission. In conclusion, due to life threatening complications such as dissection, arrhythmias, compression of aneurysm and tromboembolic complications, pseudoaneurysm should be treated by surgery. KEY WORDS Chest trauma; Left atrial pseudoaneurysm; Supraventricular arrhythmias.
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Affiliation(s)
- Cemşit Karakurt
- Faculty of Medicine, Department of Pediatric Cardiology, Inonu University, Malatya
| | - Rıza Türköz
- Department of Cardiovascular Surgery, Başkent University, Istanbul, Turkey
| | - Bülent Sarıtaş
- Department of Cardiovascular Surgery, Başkent University, Istanbul, Turkey
| | - Serkan Çelik
- Faculty of Medicine, Department of Pediatric Cardiology, Inonu University, Malatya
| | - Özlem Elkıran
- Faculty of Medicine, Department of Pediatric Cardiology, Inonu University, Malatya
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Ruttkay T, Scheid M, Gotte J, Doll N. Endoscopic Resection of a Giant Left Atrial Appendage. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2015. [DOI: 10.1177/155698451501000412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Tamas Ruttkay
- Department of Cardiac Surgery, Sana Cardiac Surgery Stuttgart GmbH, Stuttgart, Germany
| | - Michael Scheid
- Department of Cardiac Surgery, Sana Cardiac Surgery Stuttgart GmbH, Stuttgart, Germany
| | - Julia Gotte
- Department of Cardiac Surgery, Sana Cardiac Surgery Stuttgart GmbH, Stuttgart, Germany
| | - Nicolas Doll
- Department of Cardiac Surgery, Sana Cardiac Surgery Stuttgart GmbH, Stuttgart, Germany
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Gan GCH, Bhat A, Desai H, Eshoo S. Cardiac Vignette: Giant Left Atrial Appendage Aneurysm. Heart Lung Circ 2015; 24:e81-5. [PMID: 25778624 DOI: 10.1016/j.hlc.2015.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 02/09/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND The left atrial appendage (LAA) is a vestigial structure located in the postero-lateral aspect of the left atrium. Aneurysmal enlargement of the LAA is pathological and can predispose to adverse events, including myocardial infarction, atrial fibrillation and systemic thromboembolism. The condition is rare and usually isolated, occurring in the absence of other cardiac defects. In this cardiac vignette, we describe a case of giant left atrial appendage in a middle aged female presenting with chest pain and explore the natural history, different investigative modalities as well as issues in clinical management of this condition.
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Affiliation(s)
- Gary C H Gan
- Department of Cardiology, Blacktown and Mount Druitt Hospital, Sydney, NSW, Australia.
| | - Aditya Bhat
- Department of Cardiology, Blacktown and Mount Druitt Hospital, Sydney, NSW, Australia
| | - Himanshu Desai
- Department of Cardiology, Blacktown and Mount Druitt Hospital, Sydney, NSW, Australia
| | - Suzanne Eshoo
- Department of Cardiology, Blacktown and Mount Druitt Hospital, Sydney, NSW, Australia
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Abstract
Percutaneous left atrial appendage (LAA) closure is being increasingly used as a treatment strategy to prevent stroke in patients with atrial fibrillation (AF) who have contraindications to anticoagulants. Several approaches and devices have been developed in the last few years, each with their own unique set of advantages and disadvantages. In this article, the published studies on surgical and percutaneous approaches to LAA closure are reviewed, focusing on stroke mechanisms in AF, LAA structure and function relevant to stroke prevention, practical differences in procedural approach, and clinical considerations surrounding management.
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Affiliation(s)
- Faisal F Syed
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA
| | - Christopher V DeSimone
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA
| | - Paul A Friedman
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA
| | - Samuel J Asirvatham
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA; Department of Pediatrics and Adolescent Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
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Abstract
This case series describe two patients with giant aneurysms of the atrial appendages. This report discusses the clinical symptoms, imaging modalities, indications for surgical intervention, and histology of atrial appendage aneurysms.
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Affiliation(s)
- Sean M Lang
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA ; Department of Pediatrics, Section of Pediatric Cardiology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Kevin E Hall
- Department of Pediatrics, Section of Pediatric Cardiology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Abbas Haider Zaidi
- Department of Cardiology, Children's Hospital Boston, Boston, Mass, USA ; Department of Pediatrics, Harvard Medical School, Boston, Mass, USA
| | - Tal Geva
- Department of Cardiology, Children's Hospital Boston, Boston, Mass, USA ; Department of Pediatrics, Harvard Medical School, Boston, Mass, USA
| | - Stephen P Sanders
- Department of Cardiology, Children's Hospital Boston, Boston, Mass, USA ; Department of Pediatrics, Harvard Medical School, Boston, Mass, USA
| | - Pedro J Del Nido
- Department of Cardiac Surgery, Children's Hospital Boston, Mass, USA ; Department of Surgery, Harvard Medical School, Boston, Mass, USA
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Aryal MR, Hakim FA, Ghimire S, Ghimire S, Giri S, Pandit A, Bhandari Y, Bhandari N, Pathak R, Karmacharya P, Pradhan R. Left atrial appendage aneurysm: a systematic review of 82 cases. Echocardiography 2014; 31:1312-8. [PMID: 24976376 DOI: 10.1111/echo.12667] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Aneurysm of the left atrial appendage is rare. We sought to systematically review the published literature on left atrial appendage aneurysm (LAAA) to address its demographic features, clinical characteristics, treatment, complications, and outcomes. METHODOLOGY A systematic electronic search of Medline, PubMed, and EMBASE for case reports, case series, and related articles of LAAA published from 1962 until July 2013 was carried out. Statistical analysis was done using SPSS version 20.0. Logistic Regression Analysis was used to identify the independent predictors of LAAA-related thrombus formation and embolism. RESULTS Eighty-two cases of LAAA were identified. There was a slight female preponderance and most of the patients presented in their third decades. Palpitation, dyspnea or both were most common clinical symptoms associated with LAAA. Echocardiography was the main diagnostic modality used and the mean size of aneurysm was 7.08 ± 3.03 × 5.75 ± 2.36 cm. Surgical resection of the aneurysm was performed in most patients with favorable results. Systemic embolism and atrial tachyarrhythmias were the two common complications associated with untreated LAAA. Presence of atrial fibrillation/flutter was the only significant predictor of thrombus formation/embolic events. CONCLUSION Aneurysm of left atrial appendage is rare and often an incidental diagnosis during echocardiography. It is important to recognize this entity since it is associated with cardiovascular morbidity and mortality by predisposing to atrial tachyarrhythmia and thromboembolism. Surgical resection is the standard of treatment in the current literature. Medical management is directed toward the treatment of thromboembolism and atrial tachyarrhythmia.
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Affiliation(s)
- Madan Raj Aryal
- Department of Internal Medicine, Reading Health System, West Reading, Pennsylvania
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Abstract
Left atrial appendage aneurysm is an extremely rare anomaly and as such has been rarely imaged or seen intraoperatively with very little accumulated management experience. The available scant published literature stresses resection on cardiopulmonary bypass as the safest and by far the most commonly applied technique. We suggest a novel alternative imaging-guided management utilising an off-pump tourniquet snare technique under live transoesophageal echocardiography.
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Kuiten WMM, de Heer LM, van Aarnhem EEHL, Onsea K, van Herwerden LA. Giant left atrial appendage: a rare anomaly. Ann Thorac Surg 2013; 96:1478-1480. [PMID: 24088468 DOI: 10.1016/j.athoracsur.2013.01.038] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 01/05/2013] [Accepted: 01/10/2013] [Indexed: 11/25/2022]
Abstract
A giant left atrial appendage is a rare congenital anomaly that has been reported on only a few occasions. We report two symptomatic patients with atrial fibrillation combined with a cerebellar infarct in one and dyspnea in the other. Both patients were treated surgically with resection of the giant left atrial appendage and radiofrequency pulmonary vein isolation. Recognition of this uncommon pathology can lead to timely surgical intervention.
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Affiliation(s)
- Wilhelmina M M Kuiten
- Department of Cardiothoracic Surgery, University Medical Centre Utrecht, The Netherlands
| | - Linda M de Heer
- Department of Cardiothoracic Surgery, University Medical Centre Utrecht, The Netherlands
| | | | - Kevin Onsea
- Department of Cardiology, University Medical Centre Utrecht, The Netherlands
| | - Lex A van Herwerden
- Department of Cardiothoracic Surgery, University Medical Centre Utrecht, The Netherlands.
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Nakai Y, Asano M, Nomura N, Mishima A. Surgical management of an aneurysm of the left atrial appendage to prevent potential sequelae. Interact Cardiovasc Thorac Surg 2013; 17:586-7. [PMID: 23739322 DOI: 10.1093/icvts/ivt252] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
An aneurysm of the left atrial appendage is an extremely rare anomaly that is commonly associated with supraventricular arrhythmia, compression of the coronary arteries, intracardiac thrombus and pulmonary venous stenosis. This condition may be caused by congenital dysplasia of the musculi pectinati and is usually diagnosed in the second to fourth decades of life. We report the surgical management of an asymptomatic 9-year old girl with this anomaly. She was referred to us because of abnormal chest X-ray findings, and investigation revealed an aneurysm of the left atrial appendage. As this condition may have potentially fatal complications, the aneurysm was completely resected under cardiac arrest with cardiopulmonary bypass to prevent recurrence and thrombus formation. We suggest that resection of an aneurysm of the left atrial appendage under cardiac arrest with cardiopulmonary bypass is a reasonable treatment option to prevent potential complications, particularly in children.
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Affiliation(s)
- Yosuke Nakai
- Department of Cardiovascular Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
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Atrial fibrillation with a giant left atrial appendage can be successfully treated with pulmonary vein antrum isolation. Neth Heart J 2012; 20:179-81. [PMID: 21604103 PMCID: PMC3303027 DOI: 10.1007/s12471-011-0166-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Clarke JR, Zvaigzne CG, Disler D, Giuffre RM, Rebeyka IM, Patton DJ. Giant Left Atrial Appendage Aneurysm in a Neonate. World J Pediatr Congenit Heart Surg 2012; 3:392-5. [DOI: 10.1177/2150135112437251] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- James R. Clarke
- Department of Diagnostic Imaging, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia
| | - Cheryl G. Zvaigzne
- Department of Pediatric Cardiology, Alberta Children’s Hospital, Calgary, Alberta, Canada
| | - Dal Disler
- Department of Pediatric Cardiology, Alberta Children’s Hospital, Calgary, Alberta, Canada
| | - R. Michael Giuffre
- Department of Pediatric Cardiology, Alberta Children’s Hospital, Calgary, Alberta, Canada
| | - Ivan M. Rebeyka
- Department of Congenital Cardiovascular Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - David J. Patton
- Department of Pediatric Cardiology, Alberta Children’s Hospital, Calgary, Alberta, Canada
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Kawata M, Imanaka K, Matsuoka T, Yamabi H. Left atrial appendage aneurysm causes severe mitral regurgitation and heart failure: Report of a successfully treated case. J Thorac Cardiovasc Surg 2012; 143:e17-8. [DOI: 10.1016/j.jtcvs.2011.09.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Revised: 09/01/2011] [Accepted: 09/26/2011] [Indexed: 10/16/2022]
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