The dangerous fifth chamber: congenital left atrial appendage aneurysm

Aneurysms of the left atrial appendage are extremely rare. Enlargement of the left atrial appendage can be congenital or acquired. Dysplasia of the left atrial muscles leads to congenital left atrial appendage aneurysm and usually presents as atrial tachyarrhythmia or embolic events in the second or third decade of life. We report a case of an asymptomatic 12-year-old child with a congenital left atrial appendage aneurysm. Transthoracic and transoesophageal echocardiography demonstrated a large left atrial appendage aneurysm without thrombus or spontaneous echo-contrast. The patient was successfully treated with surgical resection of the aneurysm.     

Left atrial appendage aneurysm: correlation of noninvasive with clinical and surgical findings: report of a case.

Congenital left atrial appendage aneurysm is rarely diagnosed on the basis of an abnormal cardiac silhouette. Patients with a left atrial appendage aneurysm often present with symptoms of systemic emboli or supraventricular arrhythmias. A patient with left atrial appendage aneurysm was diagnosed by correlation of two noninvasive techniques echocardiography and radionuclide scintiscanning. Angiography was confirmatory and aneurysmectomy was successfully performed.     

Left atrial appendage aneurysm: echocardiographic diagnostic

The left atrial appendage aneurysm is a rare condition that frequently manifests itself by heart arrhythmias or thromboembolism. We report the case of a patient with left atrial appendage aneurysm, diagnosed by echocardiography and submitted to surgical resection.     

An Unusual Cardiac Defect in a Patient with Clinical Features Overlapping Between Cardiofaciocutaneous and Noonan Syndromes

It is important to recognize the possibility of a syndromic etiology of cardiac defects when dysmorphic features and other congenital defects are present. We report a patient who presented with atrial fibrillation and was found to have an abnormal mitral valve, congenital aneurysm of the left atrial appendage, and features consistent with both Cardiofaciocutaneous syndrome and Noonan syndrome. The congenital aneurysm of the left atrial appendage was a previously unreported cardiac presentation for either syndrome. Diagnostic considerations based upon his genotype and phenotype are discussed, along with his unique cardiac presentation and treatment.     

Resolution of Thrombi in Left Atrial Appendage Aneurysm

Atrial appendage aneurysm is a rare cardiac disease and may be complicated by embolic events and rhythm disturbances. We describe a case of a congenital left atrial aneurysm presenting with a cere-brovascular accident in a 57-year-old female. The diagnosis was made by transesophageal echocardiography, which revealed the presence of intraaneurysmal thrombi. The patient initially received anticoagulant therapy and the thrombi were resolved. Subsequently, she was successfully operated on and the aneurysm was removed. This is the first report of thrombi resolution in a left atrial appendage aneurysm.     

Intrapericardial left atrial appendage aneurysm

An intrapericardial left atrial appendage aneurysm is described in a 36 year old female. She was asymptomatic except for intermittent palpitations. The aneurysm was initially diagnosed by 2D-echocardiogram and confirmed by pulmonary cineangiogram. In addition to compression and indentation of the anterolateral wall of the left ventricle, hypokinesis was noted, which we believe has not been reported previously, in association with the left atrial appendage aneurysm, and which improved after surgical resection. The patient is symptom-free at a 5 year follow-up. A review of the literature is presented.     

Giant intrapericardial aneurysm of the left atrial appendage

A young patient is reported with an aneurysm of the left atrial appendage having supraventricular arrhythmias and a period of chest pain accompanied by a rise in cardiac enzymes. Compression of the left anterior descending coronary artery by the aneurysm was felt to be responsible for the myocardial injury.     

Transesophageal echocardiography in the diagnosis of acquired aneurysms of the left atrial appendage

We report a patient with what appeared to be a pericardial cyst by transthoracic echocardiography but was, in effect, an aneurysm of the left atrial appendage as documented by transesophageal echocardiography.     

Massive left atrial appendage aneurysm presenting as supraventricular tachycardia

Left atrial appendage aneurysm is a rarely reported condition. Symptoms are absent in childhood and diagnosis is usually incidental. Systemic embolization or arrhythmia can bring these cases to medical attention. We report the case of a 12-year-old male with massive left atrial appendage aneurysm who presented with effort intolerance and supraventricular arrhythmia. The diagnosis was made by transthoracic echocardiography. Magnetic resonance imaging and left atriogram were also done before surgical resection.     

Congenital giant aneurysm of the left atrial appendage in an infant

Aneurysm of the left atrial appendage is a rare pathological condition. We describe the diagnostic work-up and surgical management of a child with giant congenital aneurysm of the left atrial appendage.     

Congenital aneurysm of the left atrial appendage

Congenital aneurysm of the left atrial appendage is a rare anomaly, usually presenting in adult life. We report the case of a 31-year-old woman with a marked prominence of the upper left heart border at the chest X-ray in whom the diagnosis of congenital aneurysm of the left atrial appendage was confirmed by cross-sectional echocardiography and computed tomography. Up to few years ago angiography was considered the method of choice in establishing the diagnosis. Cross-sectional echocardiography has recently become a safe and reliable method for diagnosing congenital aneurysm of the left atrium and should be considered in any case with abnormality of the profile of left atrium on the chest radiography.     

先天性左房瘤1例报告及文献复习

先天性左房瘤是一种罕见的心脏畸形。至今国外文献仅报告４０余例，国内仅７例。我们报告１例５岁女孩术前无症状，胸片发现左心缘扩大，超声心动图明确诊断。在体外循环下行瘤体切除，治愈出院。结合文献对本病临床特点、诊断、治疗及预后进行讨论。     

Left atrial appendage aneurysm: a rare cause of paroxysmal supraventricular tachycardia

Left atrial appendage aneurysm is a rare abnormality and a diagnostic dilemma in patients with cardiomegaly. Patients most commonly present with atrial tachyarrhythmias and thromboembolic events. Resection of the aneurysm is usually curative. We report herein the case of a 27-year-old man with massive left atrial appendage aneurysm diagnosed incidentally in the course of pre-operative evaluation for a non-cardiac surgery. The marked cardiomegaly detected in a routinely ordered pre-operative chest X-ray and the history of previous episodes of palpitation accompanied by chest discomfort guided us to the diagnosis. The diagnosis was made by transthoracic echocardiography and confirmed by angiography and then surgery.     

Congenital aneurysm of left atrial appendage.

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.     

CONGENITAL ANEURYSM OF THE LEFT ATRIUM: DIAGNOSIS AND MANAGEMENT

A case of congenital aneurysm of the left atrial appendage is presented and previously reported cases are reviewed. The diagnosis can be strongly suspected with the combination of an unusually prominent left heart border in the chest X-ray and two-dimensional echocardiographic findings of a large echo-free space close to the left atrium. The site of communication must be defined accurately and cardiac catheterisation and angiocardiography should usually be performed. Once the diagnosis is confirmed, surgery is indicated even in the asymptomatic patient because of the risk of systemic embolism.     

Aneurysm of the left atrial appendage.

A 2-year old asymptomatic girl is presented in whom the chest x-ray film led to the discovery of a grossly distorted cardiac shadow. Angiocardiography showed a giant aneurysm originating from the left atrium. At operation an intrapericardial aneurysm of the left atrial appendage, measuring 12 X 4 X 4 cm, was found. It communicated with the left atrium through an orifice measuring 3 cm. The aneurysm was excised.     

Successful treatment of atrial fibrillation by resection of a congenital aneurysm of the left heart atrium]

Atrial fibrillation occurred in a 27-year-old patient with a history of globular cardiac enlargement since childhood. Because of the probable causal relationship between the preexisting heart disease-which was supposed to be an enlargement of the left atrium-and the rhythm disturbance, we recommended a surgical intervention. Cardiac surgery revealed a congenital aneurysm of the left atrial appendage which could be resected without any complication. Postoperatively, atrial fibrillation had returned to regular sinus rhythm. The bad prognosis with a high risk of systemic embolism is the reason why early cardiac surgery should be performed after diagnosis of this rare anomaly (20 reported cases) of the left atrium.     

Left atrial appendage aneurysm in pediatrics

Left atrial appendage aneurysm (LAAA) is a rare cardiac anomaly with potentially life-threatening complications of atrial tachyarrhythmias and systemic thromboembolism. It is often diagnosed incidentally and rarely during childhood. Echocardiography is considered the primary method of LAAA diagnosis; in particular, the subxiphoid view is more useful in pediatrics. Surgical intervention and drug management are recommended to prevent potentially lethal complications. Herein, we report five cases of patients with LAAA during infancy and childhood, caused by both congenital and acquired conditions. One patient underwent surgical resection through left lateral thoracotomy without cardiopulmonary bypass and another patient underwent drug management.     

Congenital aneurysms of the left atrium with intact pericardium--value of diagnostic methods for recognition, prognosis and therapy

An intrapericardial aneurysm of the left atrial appendage in a 7-year-old girl is reported. Review of the 36 cases described up to now reveals that there is no specific age for this disease. It is therefore questioned whether this defect is really congenital in origin. Systemic embolism and serious rhythm disturbances are the most common complications; the younger the patient, the less likely they are to occur. Systemic embolism has only been described in the case of aneurysms located at the left atrial appendage, not in aneurysms of other parts of the left atrial wall. The risk of the development of rhythm disorders, however, is independent of the location within the left atrium. Clinical findings (including ECG) are nonspecific. Cardiomegaly and unusual configuration of the heart are constantly found, but are not pathognomonic. The diagnosis is usually confirmed by angiocardiography. Operation seems always to be indicated if complications are to be avoided. Operative deaths or complications during the follow-up after operation are not described. Nothing is known about the etiology of the disease.     

Post-cardioversion atrial stunning – Not to be forgotten

We present a case of a 60-year-old male who was found to be in atrial fibrillation during routine evaluation. Anticoagulation was initiated for 36 h and he was referred for TEE-guided electrical cardioversion. There was no thrombus identified in the left atrial appendage, however, the appendage was large and had a tongue-like accessory lobe along with spontaneous contrast in the left atrium and its appendage. TEE probe was not withdrawn, patient underwent successful cardioversion with 200 joules and developed a marked increase in left atrial and left atrial appendage spontaneous contrast along with the development of tear drop shaped thrombus in the left atrial appendage immediately after cardioversion, which rapidly became more dense. There was an associated marked decrease in appendage velocities. Patient was hospitalized to initiate low molecular weight heparin. This case highlights the need for vigilance in patients with an unknown duration of atrial fibrillation, who have received a short duration of anticoagulant therapy and who have adverse appendage anatomy as thrombus may develop immediately after cardioversion despite anticoagulation.