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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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Sarioglu CT, Turkekul Y, Arnaz A, Sisli E, Yalcinbas YK, Sarioglu A. Surgical Repair of Congenital Left Atrial Aneurysm and Mitral Valve Insufficiency in a Four-Year-Old Child. World J Pediatr Congenit Heart Surg 2016; 9:357-359. [DOI: 10.1177/2150135116678416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Left atrial aneurysm is an extremely rare anomaly, which can be associated with supraventricular arrhythmia, compression of coronary arteries, intracardiac thrombus, life-threatening systemic embolization, pulmonary venous obstruction, mitral valve insufficiency, and congestive heart failure. Herein, we report a four-year-old boy who had a giant aneurysm of the left atrium and severe mitral regurgitation. The aneurysm and mitral valve cleft causing severe mitral regurgitation were successfully repaired.
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Affiliation(s)
- C. Tayyar Sarioglu
- Department of Cardiovascular Surgery, Acibadem University School of Medicine, Istanbul, Turkey
- Department of Cardiovascular Surgery, Acibadem Bakirkoy Hospital, Istanbul, Turkey
| | - Yasemin Turkekul
- Department of Cardiovascular Surgery, Acibadem Bakirkoy Hospital, Istanbul, Turkey
| | - Ahmet Arnaz
- Department of Cardiovascular Surgery, Acibadem Bakirkoy Hospital, Istanbul, Turkey
| | - Emrah Sisli
- Department of Cardiovascular Surgery, Acibadem Bakirkoy Hospital, Istanbul, Turkey
| | | | - Ayse Sarioglu
- Department of Pediatric Cardiology, Acibadem University School of Medicine, Istanbul, Turkey
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3
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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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4
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Abstract
A 14-year-old boy with sudden onset of palpitations and dyspnea was found to have an intrapericardial left atrial aneurysm (15 × 12 cm). Left atrial aneurysmectomy was carried out under cardiopulmonary bypass. The patient has been symptom-free during a 1-year follow-up.
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Affiliation(s)
| | | | - Kuldip S Sidhu
- Department of Cardiovascular and Thoracic Surgery Government Medical College Amritsar, Punjab, India
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5
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Hsiao JF, Wang CL, Ho WJ, Kuo CT. Left atrial aneurysm presenting as paroxysymal atrial flutter. Int J Clin Pract 2008; 62:1294-6. [PMID: 17645511 DOI: 10.1111/j.1742-1241.2006.01034.x] [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] [Indexed: 11/30/2022] Open
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6
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Baburaj AK, Rameshwara T, Vellachamy KA, Vettath MP. Off-Pump Excision of Left Atrial Appendage Aneurysm: A Case Report. Heart Surg Forum 2006; 9:E478-9. [PMID: 16318930 DOI: 10.1532/hsf98.20051159] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Isolated congenital intrapericardial aneurysm of the left atrium (LA) or the left atrial appendage (LAA) is a rare anomaly [Zhao 1999]. The patient usually presents with features of systemic embolization, serious arrhythmia, and severe congestive cardiac failure as a complication, which can be fatal. Once the condition is diagnosed, surgery is indicated [Zhao 1999]. We report a case of congenital left atrial appendage aneurysm in a woman who underwent excision of the same.
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Affiliation(s)
- A K Baburaj
- Department of Cardiothoracic & Vascular Surgery, Malabar Institute of Medical Sciences Ltd., Kozhikode, India
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7
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Abstract
Aneurysms of the left atrium are rare abnormalities. They can be congenital or acquired. Whereas a true congenital aneurysm presents as isolated pathology, inflammatory or degenerative processes involving the endocardium are associated with the acquired type. The clinical records of 2 patients with the diagnosis of left atrial aneurysm were reviewed, along with the surgical strategies, current literature, and patient outcomes. Because of the risk of life-threatening complications, surgery is recommended even in asymptomatic cases. Resection and mitral valvuloplasty should be the treatment of choice.
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Affiliation(s)
- J M Morales
- Driscoll Children's Hospital, Corpus Christi, Texas, USA.
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8
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Gold JP, Afifi HY, Ko W, Horner N, Hahn R. Congential giant aneurysms of the left atrial appendage: diagnosis and management. J Card Surg 1996; 11:147-50. [PMID: 8811409 DOI: 10.1111/j.1540-8191.1996.tb00030.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Giant congenital intrapericardial aneurysms of the left atrial appendage and body are unusual cardiac anomalies. Only 48 cases have been previously reported in the literature, with the vast majority presenting in otherwise healthy young patients. These can present clinically with persistent arrhythmias and progress to stroke if not diagnosed and treated. Our index case is that of a 34-year-old woman discovered to have a giant left atrial aneurysm who developed intermittent palpitations with sinus tachycardia. We present a review of the literature pertaining to their diagnosis, potential morbidity, and surgical management.
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Affiliation(s)
- J P Gold
- Department of Cardiothoracic Surgery, Cornell Medical College, New York, New York, USA.
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9
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Comess KA, Labate DP, Winter JA, Hill AC, Miller DC. Congenital left atrial appendage aneurysm with intact pericardium: diagnosis by transesophageal echocardiography. Am Heart J 1990; 120:992-6. [PMID: 2220557 DOI: 10.1016/0002-8703(90)90226-n] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- K A Comess
- Department of Internal Medicine (Cardiology), Santa Clara Valley Medical Center, San Jose, CA 95128
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10
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Mohan JC, Nair M, Arora R, Khalilullah M. Congenital left atrial aneurysms: clinical characteristics and cross-sectional echocardiographic features. Int J Cardiol 1990; 26:279-83. [PMID: 2312197 DOI: 10.1016/0167-5273(90)90083-h] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Congenital intrapericardial aneurysm of the left atrial wall is a rare anomaly with protean manifestations. Subtle electrocardiographic and chest radiographic abnormalities often give a clue to this disease. This study describes clinical characteristics, cross-sectional and Doppler echocardiographic features of this anomaly in 4 young male patients.
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Affiliation(s)
- J C Mohan
- Department of Cardiology, G.B. Pant Hospital, New Delhi, India
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Stone KS, Brown JW, Canal D, Caldwell R, Hurwitz R, King H. Congenital aneurysm of the left atrial wall in infancy. Ann Thorac Surg 1990; 49:476-8. [PMID: 2310259 DOI: 10.1016/0003-4975(90)90262-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
A 5-month-old male infant with congenital left atrial aneurysm is reported. The youngest patient previously reported was 2 1/2 years old. This case is unusual because the patient was an infant and because of the degree of mitral insufficiency and acute cardiac decompensation observed in the patient.
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Affiliation(s)
- K S Stone
- Department of Surgery, Indiana University Medical Center, Indianapolis 46223
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12
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Abstract
Congenital left atrial aneurysm, without associated cardiac abnormalities, is a rare defect. We report the case of a large left atrial aneurysm filling almost the entire left hemothorax. This is the first report of this anomaly occurring in an infant less than 1 year of age.
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Affiliation(s)
- M H Kadowaki
- Department of Pediatrics, University of Chicago Hospitals, IL 60637
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13
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Abstract
A congenital intrapericardial aneurysmal dilatation of the left atrial wall was found in a 28 year old man who presented with atrial fibrillation after a syncopal event. The patient had cutaneous manifestations of neurofibromatosis. The diagnosis was made by cross sectional echocardiography and confirmed by angiocardiography. Surgical excision of the aneurysm resolved the symptoms.
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Affiliation(s)
- N Uren
- Regional Cardiothoracic Unit, Freeman Hospital, Newcastle upon Tyne
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