Congenital partial pericardial defect and herniated right atrial appendage: a rare anomaly

Left Juxtaposition of the Right Atrial Appendage: Pitfalls in Diagnosis

Several congenital anomalies of the right atrial appendage (RAA) have been described including aneurysm, herniation (in association with a pericardial defect), and left juxtaposition. The left juxtaposition of the RAA (LJRAA), first described by Birmingham in 1893 and subsequently introduced by Dixon in 1954, is usually associated with complex cardiac malformations such as obstruction of the left ventricular outflow tract. In this case report, we will describe an unusual variant of LJRAA in the absence of any other cardiac defects, which was initially misinterpreted as an aortic dissection. The correct diagnosis was made after careful reinterpretation and the use of multiple imaging modalities as highlighted.

Congenital pericardial defect: a case of right pericardial partial absence with normal parietal pleura [corrected]

Congenital pericardial defect (CPD) is a rare cardiovascular anomaly. A right-sided CPD is much rarer than left-sided defects. Usually both the pericardium and parietal pleura are absent. We report a rare case of a right partial CPD involving the right atrial appendage, suspected by computed tomography and cine magnetic resonance imaging, and confirmed by thoracoscopy, which also demonstrated a normal parietal pleura.

Congenital complete and partial absence of the left pericardium

Congenital absence of pericardium is a rare malformation. We report 2 young patients with a diagnosis of congenital absence of the pericardium. The posteroanterior view of the chest X-ray showed displacement of the left cardiac border into the left hemithorax. Unusual acoustical windows and abnormal cardiac and septal motion during echocardiography suggested the diagnosis of congenital absence of pericardium. Magnetic resonance imaging definitive confirmed diagnosis of congenital absence of pericardium.