1
|
Qin K, Teng P, Shi L, Ma L. A rare case of left atrial appendage aneurysm. J Cardiothorac Surg 2024; 19:327. [PMID: 38849837 PMCID: PMC11157939 DOI: 10.1186/s13019-024-02629-7] [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: 09/06/2023] [Accepted: 03/09/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Left atrial appendage aneurysm is a rare cardiac mass, with only a few cases reported. There are usually no specific symptoms, and a few patients visit the doctor with symptoms. CASE PRESENTATION A 20-year-old male presented to our hospital with a "pericardial cyst found by medical evaluation in another hospital for 2 years." Cardiac ultrasound performed at clinics of our hospital suggested a cystic dark area in the left ventricular lateral wall and the anterior lateral wall, consistent with a pericardial cyst and mild mitral regurgitation. After further relevant examinations and ruling out contraindications, an excision of the left atrial appendage aneurysm was performed under general anesthesia and cardiopulmonary bypass with beating-heart. The postoperative pathological results identified that: (left atrial appendage) fibrocystic wall-like tissue with a focal lining of the flat epithelium, consistent with a benign cyst. CONCLUSION Left atrial appendage aneurysms are rare and insidious. They are usually found by chance during medical evaluations. If the location is not good or the volume is too large, then compression symptoms or arrhythmia, thrombosis and other concomitant symptoms will occur. Surgical resection is presently the only effective radical cure for a left atrial appendage aneurysm.
Collapse
Affiliation(s)
- Ke Qin
- Department of Cardiovascular Surgery, The First Affifiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China
| | - Peng Teng
- Department of Cardiovascular Surgery, The First Affifiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China
| | - Liping Shi
- Department of Cardiovascular Surgery, The First Affifiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China.
| | - Liang Ma
- Department of Cardiovascular Surgery, The First Affifiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China.
| |
Collapse
|
2
|
Yan W, Xie Y, Cai P, Ma X. A giant left atrial appendage aneurysm with recurrent chest tightness and atrial tachycardia: Multimodal imaging findings. Radiol Case Rep 2022; 18:805-808. [PMID: 36589491 PMCID: PMC9794895 DOI: 10.1016/j.radcr.2022.11.062] [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: 10/27/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/23/2022] Open
Abstract
Left atrial appendage aneurysm (LAAA) is a rare cardiac anomaly that is usually incidentally found in middle-aged patients. Though initially asymptomatic, LAAA can cause some serious complications: atrial tachyarrhythmia, thromboembolism, peripheral compression, and cardiac dysfunction. Multimodal imaging technologies, especially echocardiography and computed tomography (CT) scanning play an important role in the diagnosis of LAAA. Transthoracic echocardiography (TTE) is generally used for preliminary evaluation and diagnosis of the aneurysm. CT scanning can further confirm the diagnosis by demonstrating the spatial structure relationships and eliminating the possibility of other cardiac tumors. The following case study pertains to a 54-year-old patient with recurrent chest tightness and atrial tachycardia. The patient was diagnosed with a giant LAAA by multimodal imaging technology, and the aneurysm was surgically removed under cardiopulmonary bypass. After 4 years of follow-up, the patient reported living a healthy life without chest discomfort, complications, or medication. Multimodal imaging can provide important information for the diagnosis and treatment of left atrial appendage aneurysms, and aneurysm resection can be an effective therapeutic approach with a good long-term prognosis.
Collapse
Affiliation(s)
- Wei Yan
- Department of Ultrasound, Wuhan Asia General Hospital, 300 Jiangcheng Ave, Wuhan 430056, China,
| | - Yu Xie
- Department of Cardiac Surgery, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
| | - Peiwei Cai
- Department of Ultrasound, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
| | - Xiaojing Ma
- Department of Ultrasound, Wuhan Asia General Hospital, 300 Jiangcheng Ave, Wuhan 430056, China
| |
Collapse
|
4
|
Blood Flow Dynamics in a Giant Left Atrial Appendage Aneurysm Visualized by 4D-Flow CMR. JACC Case Rep 2021; 3:1924-1929. [PMID: 34984354 PMCID: PMC8693266 DOI: 10.1016/j.jaccas.2021.10.009] [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: 07/20/2021] [Revised: 10/14/2021] [Accepted: 10/21/2021] [Indexed: 11/23/2022]
Abstract
Aneurysms of the left atrial appendage (LAA) are rare entities that often require surgical intervention. We demonstrate multimodality imaging features of a giant LAA aneurysm, with a focus on 3-dimensional blood flow dynamics by using 4-dimensional-flow cardiac magnetic resonance. (Level of Difficulty: Advanced.)
Collapse
|
5
|
Wang X, Liu JJ, Han JC, Sun L, Zhang Y, Gu XY, Xue C, Liu XW, He YH. Fetal atrial appendage aneurysm: Prenatal diagnosis by echocardiography and prognosis. Echocardiography 2021; 38:1228-1234. [PMID: 34075626 DOI: 10.1111/echo.15089] [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: 01/31/2021] [Revised: 04/07/2021] [Accepted: 05/03/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Congenital atrial appendage aneurysm (AAA) is a rare malformation which can coexist with potentially lethal complications. We aimed to summary echocardiographic characteristics and prognosis of fetal AAA. METHODS We retrospectively analyzed the echocardiographic data of 17 fetuses with AAA,and their outcomes or pathological reports were also collected. RESULTS Eight fetuses with left AAA (LAAA) and 9 fetuses with right AAA (RAAA) were identified. Five fetuses were diagnosed with other cardiac defects. Two fetuses with RAAA presented with arrhythmias, including atrial premature beats (n = 1) and bradyarrhythmia (n = 1). LAAA could be detected by four-chamber view (50.0%) and short-axis view (100.0%). RAAA could be detected by four-chamber view (100.0%), and view of right ventricular inflow tract (33.3%). There were three cases with mild pericardial effusion. Three cases with complex cardiac defects were selectively terminated, with confirmation of LAAA by autopsy in one case. Fourteen fetuses were born. After following 2 (range, 1-5) years, the AAA disappeared in one case with LAAA and two cases with RAAA. While, 11 cases were still diagnosed with AAA. Atrial premature beats with RAAA, which appeared in prenatal period, still persisted after birth. CONCLUSION Congenital AAA is a rare abnormality in utero. The short-axis view and the four-chamber view were the most useful views to detect fetal AAA. Fetal AAA may disappear in childhood. Atrial tachyarrhythmias in utero may exist persistently after birth. Patients with AAA should be followed up closely and appropriate intervention should be taken when complications appeared.
Collapse
Affiliation(s)
- Xin Wang
- Echocardiography Medical Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Maternal-Fetal Medicine Center in Fetal Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jing-Jing Liu
- Echocardiography Medical Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Maternal-Fetal Medicine Center in Fetal Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jian-Cheng Han
- Echocardiography Medical Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Maternal-Fetal Medicine Center in Fetal Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Lin Sun
- Echocardiography Medical Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Maternal-Fetal Medicine Center in Fetal Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Ye Zhang
- Echocardiography Medical Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Maternal-Fetal Medicine Center in Fetal Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xiao-Yan Gu
- Echocardiography Medical Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Maternal-Fetal Medicine Center in Fetal Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Chao Xue
- Echocardiography Medical Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Maternal-Fetal Medicine Center in Fetal Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xiao-Wei Liu
- Echocardiography Medical Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Maternal-Fetal Medicine Center in Fetal Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yi-Hua He
- Echocardiography Medical Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Maternal-Fetal Medicine Center in Fetal Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
6
|
Zhang X, Li P, Cao Y, Li X, Duan X, Bai S, Wang F. Left atrial appendage aneurysm in pediatrics. Echocardiography 2020; 37:917-921. [DOI: 10.1111/echo.14677] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 03/25/2020] [Accepted: 04/17/2020] [Indexed: 12/30/2022] Open
Affiliation(s)
- Xin Zhang
- Heart Center Beijing Children's HospitalCapital Medical UniversityNational Center for Children’s Health Beijing China
| | - Pei Li
- Heart Center Beijing Children's HospitalCapital Medical UniversityNational Center for Children’s Health Beijing China
| | - Yongli Cao
- Imaging Center Beijing Children's HospitalCapital Medical UniversityNational Center for Children’s Health Beijing China
| | - Xiaofeng Li
- Heart Center Beijing Children's HospitalCapital Medical UniversityNational Center for Children’s Health Beijing China
| | - Xiaomin Duan
- Imaging Center Beijing Children's HospitalCapital Medical UniversityNational Center for Children’s Health Beijing China
| | - Song Bai
- Heart Center Beijing Children's HospitalCapital Medical UniversityNational Center for Children’s Health Beijing China
| | - Fangyun Wang
- Heart Center Beijing Children's HospitalCapital Medical UniversityNational Center for Children’s Health Beijing China
| |
Collapse
|