A sudden infant death associated with atrial septal aneurysm and abnormality of the connecting site between the inferior vena cava and right atrium |
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| Affiliation: | 1. Department of Forensic Medicine, Saitama Medical University, Saitama, Japan;2. Department of Forensic Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan;3. Tokyo Medical Examiner’s Office, Tokyo, Japan;4. Department of Forensic Medicine, Hirosaki University Graduate School of Medicine, Aomori, Japan;1. Department of Anatomy, Catholic Institute for Applied Anatomy, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea;2. Division of Forensic Odontology and Disaster Oral Medicine, Department of Forensic Science, Iwate Medical University, 1-1-1, Idaidori, Yahaba-cho, Shiwa-gun, Iwate 028-3694, Japan;1. Department of Pediatric Dentistry, Virginia Commonwealth University, 520 North 12th Street, Richmond, VA 23298, USA;2. Department of Developmental Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA;3. Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, Guy’s Hospital, Tower Wing, Great Maze Pond, London Bridge, London SE1 9RT, UK;1. Research and Education Faculty, Medical Sciences Cluster, Health Service Center, Kochi University, Kochi, Japan;2. National Research Institute of Police Science, Chiba, Japan;1. Legal Medicine, Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, Italy;2. Department G.F. Ingrassia, Laboratory of Forensic Toxicology, University of Catania, 95123 Catania, Italy;3. Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy;1. First Department of Forensic Science, National Research Institute of Police Science, 6-3-1 Kashiwanoha, Kashiwa, Chiba 277-0882, Japan;2. Department of Biostatistics, Graduate School of Medicine, Hokkaido University, Nishi 15, Kita 7, Sapporo, Hokkaido 060-8638, Japan;3. Department of Forensic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan;1. University of Goettingen, (Univ.-Prof. Emeritus), Fiorilloweg 1, D – 37075 Goettingen, Germany;2. Department of Diagnostic Radiology I, University Hospital of Goettingen, Robert-Koch-Str. 40, D – 37073 Goettingen, Germany;3. Institute of Forensic Medicine, Justus-Liebig-University Giessen, Frankfurter Str. 58, D – 35392 Giessen, Germany |
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| Abstract: | An atrial septal aneurysm (ASA) is a rare cardiac anomaly characterized by varicose bulging of the atrial septum (oval fossa) into the left or right atrium. Pathogenesis and clinical significance of ASA are controversial. We report an autopsy case of a huge undiagnosed ASA with abnormality of the connecting site between the inferior vena cava and the right atrial ostium in a 2-month-old Japanese female who died suddenly and unexpectedly. She was born at 36 weeks 4 days (body weight 3,110 g). No abnormality was detected during pregnancy or delivery. The postnatal growth was normal with no cardiac problem detected at the 1-month checkup. The ASA bulged off in a mass to the left atrium (width, 0.8 cm; excursion ratio, 53%), reaching close to the inflow site of the right pulmonary vein, with dilation of the pulmonary vein. The connecting site between the inferior vena cava and the right atrium was atypically located 1.6 cm away from the atrioventricular groove. Although most cases of ASA in an infant resolve physiologically as the infant grows, the infant in the present case is thought to have had an exceptional pathological ASA, possibly causing supraventricular arrhythmia. The abnormality of the connecting site between the inferior vena cava and the right atrium might have affected the development and continuation of the ASA. |
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| Keywords: | Atrial septal aneurysm Inferior vena cava Infant Sudden infant death Congenial heart disease |
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