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Harland DR, Suma V, Muthukumar L, Port SC, Werner PH, Tajik AJ. Giant Congenital Left Atrial Appendage Aneurysm Presenting With Recurrent Supraventricular Tachycardia and Chest Pain. ACTA ACUST UNITED AC 2019; 3:129-132. [PMID: 31286094 PMCID: PMC6588733 DOI: 10.1016/j.case.2019.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Daniel R Harland
- Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, University of Wisconsin School of Medicine and Public Health, Milwaukee, Wisconsin
| | - Valentin Suma
- Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, University of Wisconsin School of Medicine and Public Health, Milwaukee, Wisconsin
| | - Lakshmi Muthukumar
- Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, University of Wisconsin School of Medicine and Public Health, Milwaukee, Wisconsin
| | - Steven C Port
- Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, University of Wisconsin School of Medicine and Public Health, Milwaukee, Wisconsin
| | - Paul H Werner
- Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, University of Wisconsin School of Medicine and Public Health, Milwaukee, Wisconsin
| | - A Jamil Tajik
- Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, University of Wisconsin School of Medicine and Public Health, Milwaukee, Wisconsin
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2
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Surgical resection of a left auricular aneurysm in a dog. J Vet Cardiol 2019; 23:15-20. [PMID: 31174725 DOI: 10.1016/j.jvc.2018.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 12/12/2018] [Accepted: 12/14/2018] [Indexed: 12/12/2022]
Abstract
Aneurysmal dilation of the atrial appendage (auricle) is rare in humans and dogs. Congenital and acquired etiologies are hypothesized. Although right auricular aneurysm has been described in dogs, this is the first case report of an aneurysm of the left auricle of a dog with an intact pericardium. In humans, because complications of arrhythmia and thromboembolic disease have been reported, surgical resection of left auricular aneurysm is recommended. This report describes the successful surgical resection of a left auricular aneurysm in a dog, including a one-year follow up. Surgical resection can be considered in dogs with auricular aneurysm.
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Nezafati MH, Nazari Hayanou H, Kahrom M, Khooei A, Nezafati P. Five chambered heart: case of a huge left atrial appendage aneurysm. Cardiovasc Pathol 2018; 34:43-45. [PMID: 29574291 DOI: 10.1016/j.carpath.2018.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 02/17/2018] [Accepted: 02/22/2018] [Indexed: 11/30/2022] Open
Abstract
Aneurysmal enlargement of the left atrial appendage is an extremely rare pathology and can predispose to adverse events, including cardiac arrest, respiratory distress, arrhythmia, heart failure, systemic thromboembolism, or rupture. It is usually diagnosed incidentally or after the occurrence of atrial tachyarrhythmias or thrombotic events in the second to fourth decades of life. We describe a rare case of a symptomatic giant congenital left atrial appendage aneurysm (LAAA) in a 26-year-old man presenting with neurologic event, in whom surgical resection of the aneurysm was successfully performed. This is the largest LAAA reported in the literature so far.
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Affiliation(s)
| | | | - Mahdi Kahrom
- Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Khooei
- Department of Pathology, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Pouya Nezafati
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medicine Sciences, Isfahan, Iran.
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4
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Abstract
A 20 year-old woman presented with systemic embolisation. On subsequent investigation, she was diagnosed with a congenital left atrial appendage aneurysm. Few case reports are reported in the literature. This cardiac malformation presents a diagnostic challenge in patients with cardiomegaly.
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5
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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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6
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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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Nakahara T, Minakata K, Yamazaki K, Funamoto M, Sakata R. Bilateral atrial appendage aneurysms associated with atrial fibrillation. Asian Cardiovasc Thorac Ann 2013; 22:347-9. [DOI: 10.1177/0218492312472513] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aneurysm of the left atrial appendage is an extremely rare anomaly. We describe the case of a 68-year-old man who presented with palpitation and was found to have a very large aneurysm located near the left atrial appendage on routine echocardiography. During surgery, an additional small aneurysm of the right atrial appendage was found. Both atrial aneurysms were resected in addition to mitral annuloplasty and a maze procedure.
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Affiliation(s)
- Takahiro Nakahara
- Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kenji Minakata
- Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazuhiro Yamazaki
- Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masaki Funamoto
- Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ryuzo Sakata
- Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
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8
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Sarin SS, Bindra T, Chhabra GS. A giant left atrial appendage aneurysm with a large pinball-like thrombus in a 2 year old. Ann Pediatr Cardiol 2012; 5:215-6. [PMID: 23129921 PMCID: PMC3487220 DOI: 10.4103/0974-2069.99634] [Citation(s) in RCA: 4] [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: 01/20/2023] Open
Abstract
Congenital left atrial appendage aneurysm is very rare. We describe a giant left atrial appendage aneurysm with a pinball-like mobile thrombus in a 2-year-old child with cardioembolic stroke. Patient underwent successful surgical resection of the aneurysm.
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Affiliation(s)
- Simarjot Singh Sarin
- Department of Cardiology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India
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Wilson D, Kalra N, Brody EA, Van Dyk H, Sorrell VL. Left Atrial Appendage Aneurysm-A Rare Anomaly with an Atypical Presentation. CONGENIT HEART DIS 2009; 4:489-93. [DOI: 10.1111/j.1747-0803.2009.00319.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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10
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Congenital left atrial appendage aneurysm: a case report and brief review of literature. Heart Lung Circ 2008; 18:412-6. [PMID: 19119072 DOI: 10.1016/j.hlc.2008.10.015] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2007] [Revised: 05/05/2008] [Accepted: 10/03/2008] [Indexed: 02/08/2023]
Abstract
A 28-year-old woman with congenital aneurysm of the left atrial appendage was successfully treated by aneurysmectomy and is reported for its rarity. The exact diagnosis is relatively easy to make by contrast echocardiography, magnetic resonance imaging, and/or computerised tomographic angiography, provided the possibility is entertained. Because of supraventricular arrhythmias and systemic thromboembolism, surgical resection was deemed the best curative option to avoid further episodes and recurrence. Published reports detailing the diagnostic evaluation and surgical management for congenital left atrial appendage aneurysm are also discussed.
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Left Atrial Appendage Aneurysm: A Rare Cause of Paroxysmal Supraventricular Tachycardia. Heart Lung Circ 2008; 17:246-7. [DOI: 10.1016/j.hlc.2007.04.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2006] [Revised: 02/28/2007] [Accepted: 04/18/2007] [Indexed: 11/24/2022]
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12
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Wagshal AB, Applebaum A, Crystal P, Goldfarb B, Erez A, Tager S, Katz A. Atrial tachycardia as the presenting sign of a left atrial appendage aneurysm. Pacing Clin Electrophysiol 2000; 23:283-5. [PMID: 10709241 DOI: 10.1111/j.1540-8159.2000.tb00815.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A patient presented with atrial tachycardia. The work-up, guided by the tachycardia morphology, led to the diagnosis of left atrial appendage aneurysm. Surgical removal of the atrial appendage resulted in cure of the tachycardia and associated symptoms.
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Affiliation(s)
- A B Wagshal
- Department of Cardiology, Soroka Medical Center, Beer-Sheva, Israel
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13
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Otaki M. Surgical treatment of patients with cardiac cachexia. An analysis of factors affecting operative mortality. Chest 1994; 105:1347-51. [PMID: 8181317 DOI: 10.1378/chest.105.5.1347] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
During the period from 1982 to 1990, we operated on 25 patients with cardiac cachexia associated with a long history of combined mitral and tricuspid diseases. The age distribution was 44 to 68 years, with an average of 58 years. The overall operative mortality was 28 percent (7/25). However, the operative mortality differed according to various factors. Patients with preoperative nutritional support had a mortality rate of 17 percent, as compared with 57 percent for those without nutritional support (p < 0.05). The operative mortality was higher in patients with giant left atrium (39 percent vs 0 percent, p < 0.01). The postoperative cardiothoracic ratio in chest radiographs was significantly decreased by left atrial plication (91.6 percent vs 74.1 percent, p < 0.05). However, the operative mortality in patients with plication was still higher than in patients whose left atrium was left intact (67 percent vs 16 percent, p < 0.025). Advanced age, female sex, advanced tricuspid regurgitation, preoperative renal failure (serum urea nitrogen > 30 mg/dl), and hepatic failure (ascites or serum total bilirubin > 2.5 mg/dl) had no significant effects on operative mortality. The results demonstrated that preoperative nutritional support resulted in significant decreases in the incidence of postoperative respiratory failure and operative mortality. In contrast, postoperative respiratory failure occurred in a high percentage of patients without nutritional support even though left atrial plication was successfully performed.
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Affiliation(s)
- M Otaki
- Department of Cardiovascular Surgery, Osaka National Hospital, Japan
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14
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Trehan N, Meharwal ZS, Sharma VK. Congenital Left Atrial Aneurysm. Asian Cardiovasc Thorac Ann 1993. [DOI: 10.1177/021849239300100408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 13–year-old boy, who presented with a 4-year history of breathlessness and palpitation, was admitted with atrial fibrillation. Left atrial aneurysm was diagnosed with echocardiography and angiography. After excision of the aneurysm, the patient became asymptomatic and was in normal sinus rhythm.
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Affiliation(s)
- Naresh Trehan
- Department of Cardiovascular Surgery Escorts Heart Institute and Research Centre New Delhi, India
| | - Zile Singh Meharwal
- Department of Cardiovascular Surgery Escorts Heart Institute and Research Centre New Delhi, India
| | - Vijay Kumar Sharma
- Department of Cardiovascular Surgery Escorts Heart Institute and Research Centre New Delhi, India
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15
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Kwan CM, Tsai LM, Lin LJ, Yang YJ, Chen JH. Congenital left atrial appendage aneurysm with thrombus formation: diagnosis by transesophageal echocardiography. JOURNAL OF CLINICAL ULTRASOUND : JCU 1993; 21:480-483. [PMID: 8370812 DOI: 10.1002/jcu.1870210715] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Affiliation(s)
- C M Kwan
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China
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16
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Abstract
Left atrial appendage aneurysm is a rare anomaly, which usually presents with arrhythmia or cerebral embolism. Diagnostic evaluation traditionally required cardiac catheterization, and surgical resection required cardiopulmonary bypass. Utilizing intraoperative transesophageal echocardiography and surgical stapling devices, we have streamlined our operative technique, allowing resection of a left atrial appendage aneurysm without cardiopulmonary bypass. This report of two cases treated over the past decade demonstrates the evolution of our surgical technique.
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Affiliation(s)
- R P Burke
- Department of Surgery, Harvard Medical School, Boston, Massachusetts
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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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Okita Y, Miki S, Tamura T, Kusuhara K, Ueda Y, Tahata T, Yamanaka K, Sasakabe H. Multiple congenital aneurysms of the atria. Ann Thorac Surg 1990; 49:672-3. [PMID: 2322067 DOI: 10.1016/0003-4975(90)90326-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Aneurysms of both the left and right atria are very rare congenital abnormalities. A 3-year-old boy underwent operation with preoperative diagnosis of aneurysms of both atria and supraventricular tachyarrhythmia. The multiple aneurysms were resected during cardiopulmonary bypass. The patient was asymptomatic after operation and has maintained sinus rhythm.
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Affiliation(s)
- Y Okita
- Department of Cardiovascular Surgery, Tenri Hospital, Nara, Japan
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Vargas-Barron J, Sanchez-Ugarte T, Keirns C, Vazquez-Sanchez J, Fernandez-Vazquez F, Barragan R. The differential diagnosis of partial absence of left pericardium and congenital left atrial aneurysm. Am Heart J 1989; 118:1348-50. [PMID: 2686387 DOI: 10.1016/0002-8703(89)90033-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- J Vargas-Barron
- Department of Echocardiography, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico DF
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20
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LaBarre TR, Stamato NJ, Hwang MH, Jacobs WR, Stephanides L, Scanlon PJ. Left atrial appendage aneurysm with associated anomalous pulmonary venous drainage. Am Heart J 1987; 114:1243-5. [PMID: 3673894 DOI: 10.1016/0002-8703(87)90206-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- T R LaBarre
- Section of Cardiology, Hines Veterans Administration Hospital, IL 60141
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Pinamonti B, Alberti E, Buttignol G, Cristaldi A, Camerini F. Echocardiographic diagnosis of congenital left atrial aneurysm. Am Heart J 1986; 111:406-9. [PMID: 3946182 DOI: 10.1016/0002-8703(86)90160-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Abstract
Congenital intrapericardial aneurysmal dilatation of the left atrial appendage is a rare but correctable lesion. One such patient who underwent aneurysmectomy is described, and the literature is reviewed.
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23
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Abstract
Left atrial aneurysm is a rare condition. Only 29 cases have been reported, to our knowledge. We report 1 such case in a 24-year-old man who complained of dyspnea and arrhythmias. Diagnosis was suspected on review of chest roentgenogram and confirmed by echocardiography and cardiac catheterization. Surgical repair was achieved without complications, and preoperative symptoms disappeared completely. According to the literature, these patients are almost always asymptomatic. When present, the most common symptoms are arrhythmias, heart failure, emboli, and chest pain. This lesion is seen mainly in young adults (mean age, 23.5 years). The diagnosis should be confirmed by echocardiography, nuclear imaging, and cardiac catheterization. A review of the literature indicates that surgical repair can be accomplished with low mortality and that arrhythmias usually disappear postoperatively.
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Lipkin D, Colli A, Somerville J. Aneurysmal dilatation of left atrial appendage diagnosed by cross sectional echocardiography and surgically removed. BRITISH HEART JOURNAL 1985; 53:69-71. [PMID: 3966953 PMCID: PMC481724 DOI: 10.1136/hrt.53.1.69] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
An isolated aneurysmal dilatation of the left atrial appendage was found in an 18 year old girl who presented with atrial fibrillation and an unusual cardiac shadow on routine chest radiographs. The diagnosis was made by cross sectional echocardiography. The giant appendage was excised to remove the risk of systemic embolism and the need for life long anticoagulation.
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Bramlet DA, Edwards JE. Congenital aneurysm of left atrial appendage. BRITISH HEART JOURNAL 1981; 45:97-100. [PMID: 7459169 PMCID: PMC482494 DOI: 10.1136/hrt.45.1.97] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Congenital aneurysm of the left atrial appendage is a rare anomaly, usually presenting in adult life. The case reported is that of a 55-year-old man who died of cerebral embolism originating from a thrombus in a congenital aneurysm of the left atrial appendage. The cardiac silhouette 11 years previously had suggested a cardiac tumour or a pericardial cyst. As judged frm 14 published cases, the major manifestations of these aneurysms are an abnormal cardiac silhouette in the x-ray, supraventricular tachycardia, and systemic embolism. Angiocardiography appears to be the method of choice in establishing the diagnosis. Resection of th aneurysm is the recommended form of treatment.
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Abstract
A 24-year-old housewife with congenital aneurysm of the left atrial appendage underwent a successful operation for its removal. Operation, using cardiopulmonary bypass, is indicated in all patients with atrial aneurysm. The procedure has proved uniformly safe and successful.
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de Feyter PJ, Zienkowicz BS, Heidendal GA, Majid PA, Roos JP. Radionuclide angiography in the diagnosis of congenital intrapericardial aneurysm of the left atrial appendage. Thorax 1980; 35:154-5. [PMID: 7376121 PMCID: PMC471243 DOI: 10.1136/thx.35.2.154] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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