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Pedro B, Sarcinella F, Linney C, Neves J, Mesquita L. Congenital right atrial diverticulum in a kitten. J Vet Cardiol 2024; 53:1-5. [PMID: 38520764 DOI: 10.1016/j.jvc.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 02/21/2024] [Accepted: 02/23/2024] [Indexed: 03/25/2024]
Abstract
A four-month-old domestic shorthair cat with no clinical signs was referred for further examination of a heart murmur. An echocardiogram revealed marked right atrial dilation, extending into the left hemithorax. Computed tomography angiography was conducted to investigate further, which revealed a balloon-shaped, contrast-filled cavity on the cranial and left side of the chest that connected to the right atrium through a narrow passage. This was diagnosed as a congenital right atrial diverticulum. Treatment included clopidogrel to reduce the risk of thrombus formation. Two months after the initial diagnosis, castration surgery was successfully performed without complications. The cat died suddenly at home 10 months after diagnosis. To the authors' knowledge, this is the first right atrial diverticulum reported in a cat.
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Affiliation(s)
- B Pedro
- Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull, B90 4NH, United Kingdom; Virtual Veterinary Specialists, 166 College Road, Harrow, Middlesex, HA1 1BH, United Kingdom; Hospital Veterinario do Bom Jesus, Avenida General Carrilho da Silva Pinto 52, 4715-380, Braga, Portugal.
| | - F Sarcinella
- Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull, B90 4NH, United Kingdom
| | - C Linney
- Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull, B90 4NH, United Kingdom; Paragon Veterinary Referrals, Paragon Business Village, Paragon Way, Wakefield, WF1 2DF, United Kingdom
| | - J Neves
- Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull, B90 4NH, United Kingdom; Virtual Veterinary Specialists, 166 College Road, Harrow, Middlesex, HA1 1BH, United Kingdom; Hospital Veterinario do Bom Jesus, Avenida General Carrilho da Silva Pinto 52, 4715-380, Braga, Portugal; Hospital Veterinario de Aveiro, Avenida da Universidade 215, 3810-489 Aveiro, Portugal
| | - L Mesquita
- Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull, B90 4NH, United Kingdom; AniCura CHV Porto, Hospital Veterinario, Rua Manuel Pinto de Azevedo 118, 4100-321, Porto, Portugal
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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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Stabile M, Cipullo LMA, Carlucci S, Rispoli AF, Stabile G. Prognostic dilemmas for SIDS in idiopathic fetal right atrium dilatation: Case report and review literature. J Neonatal Perinatal Med 2023; 16:741-746. [PMID: 38043023 DOI: 10.3233/npm-230137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2023]
Abstract
The authors describe a case of fetal isolated right atrial enlargement or IDRA (idiopathic dilatations of the right atrium) evident in third trimester, complicated by arrhythmia in the female infant during the 1° month of life with ECG diagnosis of Wolf-Parkinson-White syndrome (WPW). The eldest sister died at 6 years because of an arrhythmia with the same diagnosis of WPW. The review of the literature on IDRA frequently shows a familial genetic aggregation. The pathogenetic mechanism underlying the dilation of the right atrium could consist of a myopathy or electrical conduction disorder. The exclusive involvement of the right atrium may be due to the increased pressure in the fetal right atrium. On the basis of our case and after review of the literature, we must be careful in defining as physiological the enlargement of the right fetal atrium in the third trimester of pregnancy. The ultrasound sign of IDRA may be a fetal prodrome of SIDS (sudden infant death syndrome).
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Affiliation(s)
- M Stabile
- Prenatal Diagnosis, Fertility, Zygote Center, Center for Genetics, Salerno, Italy
| | - L M A Cipullo
- Departments of Obstetrics and Gynecology, Azienda Ospedaliera Universitaria, San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy
| | - S Carlucci
- Departments of Obstetrics and Gynecology, IRCCS Burlo Garofolo, Trieste, Italy
| | - A F Rispoli
- Prenatal Diagnosis, Fertility, Zygote Center, Center for Genetics, Salerno, Italy
| | - G Stabile
- Departments of Obstetrics and Gynecology, IRCCS Burlo Garofolo, Trieste, Italy
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Mirhosseini SM, Beheshti Monfared M, Khani M, Jafari Naeini S. Surgical repair of a giant congenital right atrial aneurysm concomitant with Wolff‐Parkinson‐White syndrome: A case report and literature review. Clin Case Rep 2022; 10:e05743. [PMID: 35449769 PMCID: PMC9014696 DOI: 10.1002/ccr3.5743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/09/2022] [Accepted: 03/28/2022] [Indexed: 12/03/2022] Open
Abstract
Congenital right atrial aneurysms (RAA) have a wide range of clinical presentations and leads to various complications. Depending on the initial presentation and associated complications, a conservative or surgical approach may be considered. A patient suffering from a giant RAA associated with the Wolff‐Parkinson‐White syndrome, who underwent successful surgical treatment, is presented here.
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Affiliation(s)
| | - Mahmood Beheshti Monfared
- Department of Cardiovascular Surgery Shahid Modarres Hospital Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Mohammad Khani
- Shahid Modarres Hospital Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Sepideh Jafari Naeini
- Cardiovascular research center Shahid Beheshti University of medical sciences Tehran Iran
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5
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Papa M, Gendusa M, Borgonovo S, Boz E, Corbari A, Rossi C, Signorelli S, Noto F, Ghilardi S, Bussadori CM. Diagnosis of congenital aneurysmal giant right auricle in a dog. J Vet Cardiol 2022; 41:172-178. [DOI: 10.1016/j.jvc.2022.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 02/17/2022] [Accepted: 02/25/2022] [Indexed: 11/29/2022]
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6
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Dang HQ, Tran MT, Le HT. Totally Endoscopic Resection of Right Atrial Diverticulum: A Case Report. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2022; 17:159-161. [PMID: 35112921 DOI: 10.1177/15569845211062855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Right atrial diverticulum is a rare congenital heart defect with only about 30 cases reported. Surgery is the main method of treatment and is indicated when the patients have signs of right heart compression. In this study, we report the case of a 43-year-old male patient who was diagnosed with massive right atrial diverticulum. This patient was the first case who underwent successful repair by totally endoscopic surgery on the beating heart.
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Affiliation(s)
- Huy Q Dang
- Minimally Invasive Cardiac Surgery Unit, Cardiovascular Center, 434418Hanoi Heart Hospital, Vietnam
| | - Manh T Tran
- Department of Cardiac Radiology, 434418Hanoi Heart Hospital, Vietnam
| | - Huong T Le
- Institutes of Preventive Medicine and Public Health, 106156Hanoi Medical University, Vietnam
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Ivanitskaya O, Sologub Y, Tsayuk Y, Zagray A, Kim A. Right atrial appendage aneurysm in a fetus-Does precise prenatal diagnosis matter? ULTRASOUND (LEEDS, ENGLAND) 2020; 28:255-259. [PMID: 36959897 PMCID: PMC10028379 DOI: 10.1177/1742271x20941186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 06/16/2020] [Indexed: 11/17/2022]
Abstract
Introduction Congenital malformations of the right atrium-aneurysms and diverticula-are rare heart defects with only a few cases having been described prenatally. Early diagnosis of these anomalies is extremely important due to the possibility of such serious complications such as supraventricular arrhythmia, thromboembolic events and sudden death. Topic Description Although each of these anomalies is well known, there are still significant discrepancies in diagnosis. At the same time, there is no essential difference in the postnatal management of patients with right atrial aneurysms or diverticula. Treatment mode varies between centers and is selected individually depending on the presence of symptoms. Discussion We discuss the problems of terminology, ultrasound criteria and prenatal differential diagnosis, anatomic and histological features and current limitations for the accurate diagnosis of right atrial aneurysms and diverticula in utero. As a clinical example, we describe a case of right atrial appendage aneurysm diagnosed in a fetus. Conclusions Considering the prenatal diagnostic difficulties and similar management of such patients after birth, we suggest avoiding the use of exact terms in the fetus, leaving the precise diagnosis for the postnatal period.
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Affiliation(s)
- Olga Ivanitskaya
- Medical Genetics Department, Moscow Regional Research Institute of
Obstetrics and Gynecology, Moscow, Russian Federation
- Olga Ivanitskaya, Moscow Regional Research Institute
of Obstetrics and Gynecology, 22a-Pokrovka str, Moscow 101000, Russian Federation.
| | - Yulia Sologub
- Department of Diagnostic Radiology, Kolomna Perinatal Center, Kolomna,
Moscow Region, Russian Federation
| | - Yulia Tsayuk
- Medical Genetics Department, Moscow Regional Research Institute of
Obstetrics and Gynecology, Moscow, Russian Federation
| | - Alexey Zagray
- Department of Urgent Surgery of Congenital Heart Defects, A.N. Bakulev
National Medical Research Center of Cardiovascular Surgery, Moscow, Russian
Federation
| | - Aleksei Kim
- Department of Reconstructive Surgery for Newborns and Children of the
First Year of Life with CHD, A.N. Bakulev National Medical Research Center of
Cardiovascular Surgery, Moscow, Russian Federation
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8
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Park S, Kittleson M, Yu D, Choi J. Echocardiographic Features of Giant Right Atrial Diverticulum in a Dog. Vet Med (Auckl) 2017; 31:879-883. [PMID: 28463475 PMCID: PMC5435045 DOI: 10.1111/jvim.14712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 02/03/2017] [Accepted: 03/09/2017] [Indexed: 11/26/2022]
Abstract
A 12‐year‐old spayed female miniature Poodle presented for coughing, respiratory distress, and anorexia. After thoracentesis for pleural effusion, radiography revealed an enlarged cardiac silhouette with a bulge in the area of the body of the right atrium. Echocardiography revealed an anechoic chamber‐like cavity lateral to the right atrium that communicated with the right atrium through a 13 mm defect in the right atrial free wall. Contrast echocardiography and color flow Doppler were used to prove that the cavity communicated with the right atrium. The cavity was diagnosed as a giant right atrial diverticulum.
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Affiliation(s)
- S. Park
- College of Veterinary Medicine and BK 21 Plus Project TeamCollege of Veterinary MedicineChonnam National UniversityGwangjuKorea
| | - M.D. Kittleson
- Department of Medicine and EpidemiologySchool of Veterinary MedicineUniversity of California DavisDavisCA
| | - D. Yu
- College of Veterinary Medicine and BK 21 Plus Project TeamCollege of Veterinary MedicineChonnam National UniversityGwangjuKorea
| | - J. Choi
- College of Veterinary Medicine and BK 21 Plus Project TeamCollege of Veterinary MedicineChonnam National UniversityGwangjuKorea
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9
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Pawar RS, Tiwari A, Suresh PV, Raj V, Kaushik P. A Case of Giant Right Atrial Aneurysm in a Child. World J Pediatr Congenit Heart Surg 2016; 7:516-9. [PMID: 26884450 DOI: 10.1177/2150135115607189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Accepted: 08/26/2015] [Indexed: 11/16/2022]
Abstract
Giant right atrial aneurysm is a rare entity in infants and children. It needs to be distinguished from an atrial diverticulum, which can have similar presentation. Generally, an incidental finding in children, it can present with varied symptoms. We report a case of a giant right atrial aneurysm in an asymptomatic child with a large clot in the dilated right atrium, who underwent successful resection of the atrial aneurysm.
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Affiliation(s)
- Ravindra S Pawar
- Department of Pediatric Cardiology, Narayana Institute of Cardiac Sciences, Bengaluru, Karnataka, India
| | - Ashish Tiwari
- Department of Pediatric Cardiology, Narayana Institute of Cardiac Sciences, Bengaluru, Karnataka, India
| | - P V Suresh
- Department of Pediatric Cardiology, Narayana Institute of Cardiac Sciences, Bengaluru, Karnataka, India
| | - Vimal Raj
- Mazumdar Shaw Medical Centre, Bengaluru, Karnataka, India
| | - Pradeepkumar Kaushik
- Department of Pediatric Cardiology, Narayana Institute of Cardiac Sciences, Bengaluru, Karnataka, India
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10
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Ding X, Zhu M, Wei C, Zhu H, Zhang X, Qu X, Li Y, Yuan J. Double cardiac diverticula after pericardectomy. Int J Cardiol 2015; 201:449-53. [PMID: 26313864 DOI: 10.1016/j.ijcard.2015.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 08/01/2015] [Indexed: 11/17/2022]
Affiliation(s)
- Xiao Ding
- Department of Ultrasonography, The People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China
| | - Meihua Zhu
- Department of Pediatric Cardiology, Oregon Health & Science University, Portland, OR 97239, United States
| | - Changhua Wei
- Department of Ultrasonography, The People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China
| | - Haohui Zhu
- Department of Ultrasonography, The People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China
| | - Xijun Zhang
- Department of Ultrasonography, The People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China
| | - Xuezheng Qu
- Department of Ultrasonography, The People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China
| | - Yang Li
- Department of Ultrasonography, The People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China
| | - Jianjun Yuan
- Department of Ultrasonography, The People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China.
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11
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Sato Y, Satokawa H, Yamamoto A, Yokoyama H, Maehara K. Giant right atrial diverticulum with thrombus formation. Asian Cardiovasc Thorac Ann 2014; 23:314-6. [PMID: 24887889 DOI: 10.1177/0218492313504768] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A 28-year-old man was referred to our hospital with a giant right atrial diverticulum. The mass of the right atrial diverticulum compressed the right atrium and right ventricle, and thrombus formation was suspected. The diverticulum was surgically excised and the patient remained asymptomatic a year later.
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Affiliation(s)
- Yoshiyuki Sato
- Department of Cardiovascular Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hirono Satokawa
- Department of Cardiovascular Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Akihiro Yamamoto
- Department of Cardiovascular Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hitoshi Yokoyama
- Department of Cardiovascular Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kazuhira Maehara
- Department of Circulatory Internal Medicine, Shirakawa Kosei General Hospital, Fukushima, Japan
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12
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Hofmann SR, Heilmann A, Häusler HJ, Dähnert I, Kamin G, Lachmann R. Congenital Idiopathic Dilatation of the Right Atrium: Antenatal Appearance, Postnatal Management, Long-Term Follow-Up and Possible Pathomechanism. Fetal Diagn Ther 2012; 32:256-61. [DOI: 10.1159/000338661] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Accepted: 04/05/2012] [Indexed: 11/19/2022]
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13
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Anatomical analysis of incidental left atrial diverticula in patients with suspected coronary artery disease using 64-channel multidetector CT. Clin Radiol 2011; 66:961-5. [DOI: 10.1016/j.crad.2011.04.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Revised: 04/20/2011] [Accepted: 04/26/2011] [Indexed: 11/18/2022]
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Hoey ET, Nagra I, Ganeshan A. Cardiac Aneurysms and Diverticula: Magnetic Resonance and Computed Tomography Appearances. Curr Probl Diagn Radiol 2011; 40:72-84. [DOI: 10.1067/j.cpradiol.2010.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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15
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Ikonomidis I, Varounis C, Paraskevaidis I, Parissis J, Lekakis J, Anastasiou-Nana M. Congenital left ventricular aneurysm: a cause of impaired myocardial torsion and peripheral thrombo-embolic events. EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY 2010; 12:E7. [DOI: 10.1093/ejechocard/jeq103] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Nonseptal right atrial aneurysm: case report and review of literature. Cardiovasc Pathol 2009; 19:e79-83. [PMID: 19375357 DOI: 10.1016/j.carpath.2009.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2008] [Revised: 01/16/2009] [Accepted: 01/25/2009] [Indexed: 11/23/2022] Open
Abstract
An aneurysm of the portion of the right atrium classically referred to as the subeustachian sinus is reported in a 75-year-old man with cardiac amyloidosis, AL phenotype, related to underlying multiple myeloma. A review of literature confirms the rarity of nonseptal right atrial aneurysms and their propensity to involve the subeustachian area of the right atrium which may be an intrinsic area of weakness in the atrial wall. The coincident amyloidosis in our current case suggests that hemodynamic factors may have played a role in the development of the aneurysm.
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Wan Y, He Z, Zhang L, Li B, Sun D, Fu F, Qi Y, Zhang J, Li Y, Xu M, Li Y. The anatomical study of left atrium diverticulum by multi-detector row CT. Surg Radiol Anat 2008; 31:191-8. [PMID: 18923806 DOI: 10.1007/s00276-008-0427-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2008] [Accepted: 09/15/2008] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to describe radiologic anatomy of the left atrium diverticulum. There were 20 patients with 27 left atrium diverticulums in 120 consecutive patients who underwent CT of coronary angiography. The presence probability of left atrium diverticulum was 16.7%, male of it was 13.0%, female was 17.6%. There was no difference on gender (P > 0.05). There were four patients accompanying with variation of pulmonary vein at one time. The diverticulum might be single or multiple, cystiform or tubiform. It could locate anterior wall or posterior wall or superior wall of left atrium. Left atrium diverticulums which was single, cystiform, and located in anterior wall were common. The cervix width of diverticulum was 4.9 +/- 3.2 mm, the body height of them was 5.4 +/- 2.0 mm. The ratio of body height to cervix width was from 0.47 to 4.08 (median 1.16). Ten patients of them undertook cardiac ultrasound examination at same time. There were five patients who left atrial diastolic function decreased, four patients who left ventricular systolic function decreased. Three of them both existed left atrial diastolic function decreasing and left ventricular systolic function decreasing, accompanied with mitral or aortic regurgitation. No patient was found that left atrium pressure or left ventricle diastolic pressure was increasing. The left atrium diverticulums of ten patients were probably congenital because their hemodynamical status cannot lead to diverticulum formation. It can be proved by reexamination after therapy or autopsy at last. In conclusion, multi-detector row computed tomography could provide anatomy details of left atrium diverticulum to help to finish heart and chest surgery successfully.
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Affiliation(s)
- Yeda Wan
- Tianhe Hospital of Tianjin, No. 122, Munan Street, Tianjin 300050, China.
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Duerinckx AJ, Vanovermeire O. Accessory appendages of the left atrium as seen during 64-slice coronary CT angiography. Int J Cardiovasc Imaging 2007; 24:215-21. [PMID: 17577678 DOI: 10.1007/s10554-007-9240-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2007] [Accepted: 05/17/2007] [Indexed: 11/29/2022]
Abstract
PURPOSE To document the frequency and variations in number and anatomical shape of accessory appendages of the left atrium as seen on 64-slice cardiac CT. METHODS AND MATERIALS Retrospective review of the anatomy of the left atrium as depicted by cardiac CT using the acquisition protocol designed for coronary CT Angiography and performed in 166 patients over a 6-month period with a 64-slice ECG-gated CT scanner (Siemens Medical Solutions). The local IRB provided a waiver of informed consent for this retrospective study. Structures less than 5 mm in shape were excluded, as well as large accessory pulmonary veins. RESULTS Seventeen (17) of 166 patients (10%) had 18 accessory left atrial appendages (only one patient had two). Fifteen (15) accessory appendages were located along the right upper atrial wall and measured 0.9 x 0.6 x 0.5 cm(3) +/- 0.2 x 0.2 x 0.1 (Type 1). Three (3) were located along the left lower atrial wall, and were larger (0.9-2.5 cm cross-section) (Type 2). The right upper accessory appendages were mostly shaped like small diverticuli and the left lower ones were shaped like flat cauliflower expansions. CONCLUSIONS Accessory left atrial appendages were visualized in 10% of 166 patients during 64-slice coronary CT angiography.
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Affiliation(s)
- Andre J Duerinckx
- Department of Radiology, The MetroHealth System, Cleveland, OH 44109, USA.
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Kurz DJ, Oechslin EN, Kobza R, Jenni R. Idiopathic enlargement of the right atrium: 23 year follow up of a familial cluster and their unaffected relatives. Heart 2004; 90:1310-4. [PMID: 15486129 PMCID: PMC1768550 DOI: 10.1136/hrt.2003.030023] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/13/2004] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To evaluate the long term outcome of familial idiopathic enlargement of the right atrium (IERA) and the risk of developing this disorder among unaffected offspring. DESIGN 23 year follow up study. PATIENTS 14 members (eight men, mean age 54 years, range 40-78) of a pedigree with familial IERA. METHODS All patients were examined clinically and echocardiographically in 1979 and 2002. Normal cross sectional dimensions of the right atrium were derived from echocardiographic evaluation of 100 people (47% men) with no structural or haemodynamic signs of heart disease. The 90th centile was chosen as the upper normal limit. IERA was defined as an increased right atrial long axis indexed to body surface area (RALAX(i), men > 2.6 cm/m2, women > 2.8 cm/m2) in the absence of other cardiac abnormalities. Severe IERA was defined arbitrarily as RALAX(i) > or = 4 cm/m2. RESULTS The course of the two index patients with severe IERA diagnosed in 1979 was complicated by atrial fibrillation, systemic embolism, and symptoms of heart failure without systolic dysfunction, resulting in the death of one man (77 years old). One of two patients with initially mild forms progressed to severe IERA. All of the initially unaffected offspring (n = 9) remained asymptomatic, although four of them had developed mild IERA. CONCLUSIONS During 23 years' follow up, severe IERA induced atrial fibrillation, systemic embolism, and symptoms of heart failure without systolic dysfunction in all cases in this family. Mild IERA seems to become manifest during middle age and may be followed by gradual progression to clinically relevant disease.
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Affiliation(s)
- D J Kurz
- Echocardiography, Cardiovascular Centre, University Hospital, Zurich, Switzerland
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