Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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The Treatment of Left Atrial Appendage Aneurysm by a Minimally Invasive Approach

  • Kim, Young Woong (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Ho Jin (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ju, Min Ho (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Jae Won (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2017.08.28
  • Accepted : 2017.10.24
  • Published : 2018.04.05
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Abstract

Left atrial appendage (LAA) aneurysm is a rare, pathologic condition that may lead to atrial tachyarrhythmia or thromboembolic events. A 49-year-old man presented with aggravated palpitation and dizziness. He suffered from refractory atrial fibrillation despite a previous history of radiofrequency catheter ablation. Echocardiography revealed a 57-mm LAA aneurysm. Surgical ablation was performed through a right mini-thoracotomy, and the LAA aneurysm was obliterated with a 50-mm AtriClip (Atricure Inc., Westchester, OH, USA). However, follow-up computed tomography showed residual communication, so the patient is still taking warfarin. We report that a minimally invasive strategy for treating LAA aneurysm can be considered, but incomplete closure may occur; thus, caution is needed.

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References

  1. Aryal MR, Hakim FA, Ghimire S, et al. Left atrial appendage aneurysm: a systematic review of 82 cases. Echocardiography 2014;31:1312-8.
  2. Mathur A, Zehr KJ, Sinak LJ, Rea RF. Left atrial appendage aneurysm. Ann Thorac Surg 2005;79:1392-3. https://doi.org/10.1016/j.athoracsur.2003.10.020
  3. Zhao J, Ge Y, Yan H, Pan Y, Liao Y. Treatment of congenital aneurysms of the left atrium and left atrial appendage. Tex Heart Inst J 1999;26:136-9.
  4. Schneider B, Stollberger C, Sievers HH. Surgical closure of the left atrial appendage: a beneficial procedure? Cardiology 2005;104:127-32.
  5. Kiaii B, Doll N, Kuehl M, Mohr FW. Minimal invasive endoscopic resection of a giant left atrial appendage aneurysm. Ann Thorac Surg 2004;77:1437-8. https://doi.org/10.1016/S0003-4975(03)01303-1
  6. Ad N, Massimiano PS, Shuman DJ, Pritchard G, Holmes SD. New approach to exclude the left atrial appendage during minimally invasive cryothermic surgical ablation. Innovations (Phila) 2015;10:323-7.
  7. Kanderian AS, Gillinov AM, Pettersson GB, Blackstone E, Klein AL. Success of surgical left atrial appendage closure: assessment by transesophageal echocardiography. J Am Coll Cardiol 2008;52:924-9. https://doi.org/10.1016/j.jacc.2008.03.067
  8. Aryana A, d'Avila A. Incomplete closure of the left atrial appendage: implication and management. Curr Cardiol Rep 2016;18:82. https://doi.org/10.1007/s11886-016-0765-2