Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
권호 표지
DOI QR코드

DOI QR Code

Left Atrial Appendage Aneurysm: A Case Report

좌심방 부속기 동맥류: 증례 보고

  • Young Jae Choi (Department of Radiology, Dongguk University Ilsan Hospital, Dongguk University Graduate School of Medicine) ;
  • Jeung Sook Kim (Department of Radiology, Dongguk University Ilsan Hospital, Dongguk University Graduate School of Medicine) ;
  • Yoon Ki Cha (Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kang Min Han (Department of Pathology, Dongguk University Ilsan Hospital, Dongguk University Graduate School of Medicine)
  • 최영재 (동국대학교 의과대학 일산동국대학교병원 영상의학과) ;
  • 김정숙 (동국대학교 의과대학 일산동국대학교병원 영상의학과) ;
  • 차윤기 (성균관대학교 의과대학 서울삼성병원 영상의학과) ;
  • 한강민 (동국대학교 의과대학 일산동국대학교병원 병리과)
  • Received : 2021.09.08
  • Accepted : 2022.04.19
  • Published : 2022.11.01
Download PDF
⟨ Previous Next ⟩

Abstract

Left atrial appendage aneurysm (LAAA) is a rare heart anomaly caused by congenital dysplasia of the pectinate muscle or by an acquired pathological condition of the mitral valve or cardiac muscle. It is often incidentally discovered during chest CT or echocardiography as an abnormal dilatation of the LAA. LAAA is associated with life-threatening complications and most patients require surgical treatment. Therefore, it is important to evaluate associated complications as well as precise diagnoses. This report presents the case of a surgically confirmed LAAA in a 53-year-old female. We also discuss the pathophysiology of LAAA and significant findings related to mortality that can be detected on CT and MRI.

좌심방 부속기 동맥류는 심장 빗살근의 선천성 이형성이나 승모판 또는 심근의 후천적 병변에 의해 생길 수 있는 매우 드문 심장 질환이다. 주로 흉부 CT나 심초음파에서 좌심방이 비정상적 팽창되어 우연히 발견되며, 환자의 대부분은 무증상이지만 생명을 위협하는 합병증과 관련이 있어 외과적 치료를 필요로 한다. 그러므로 정확한 진단과 함께 이에 동반된 합병증을 찾아내는 것은 중요하다. 본 증례 보고에서는 수술적 치료로 확진 된 53세 여성의 좌심방 부속기 동맥류를 소개하고 병태생리학을 바탕으로 진단과 함께 놓치지 말아야 할 합병증에 대한 CT 및 MRI 검사의 소견을 소개하고자 한다.

Keywords

References

  1. Wang B, Li H, Zhang L, He L, Zhang J, Liu C, et al. Congenital left atrial appendage aneurysm: a rare case report and literature review. Medicine (Baltimore) 2018;97:e9344
  2. Hoffmann U, Hamed N, Herold C, Globits S. Radiological signs of a left atrial aneurysm. Eur Radiol 2000;10:1332-1334 https://doi.org/10.1007/s003309900307
  3. Dimond EG, Kittle CF, Voth DW. Extreme hypertrophy of the left atrial appendage: the case of the giant dog ear. Am J Cardiol 1960;5:122-125 https://doi.org/10.1016/0002-9149(60)90019-9
  4. Cuenca Castillo J. Left atrial appendage aneurysm: knowledge and gaps. JACC Case Rep 2021;3:1930-1931 https://doi.org/10.1016/j.jaccas.2021.11.002
  5. Aryal MR, Hakim FA, Ghimire S, Ghimire S, Giri S, Pandit A, et al. Left atrial appendage aneurysm: a systematic review of 82 cases. Echocardiography 2014;31:1312-1318 https://doi.org/10.1111/echo.12667
  6. Naksuk N, Padmanabhan D, Yogeswaran V, Asirvatham SJ. Left atrial appendage: embryology, anatomy, physiology, arrhythmia and therapeutic intervention. JACC Clin Electrophysiol 2016;2:403-412 https://doi.org/10.1016/j.jacep.2016.06.006
  7. Toufan M, Pourafkari L, Afrasiabi A, Sohrabi M, Nader ND. Left atrial appendage aneurysm presenting with chronic cough. Neth Heart J 2017;25:526-527 https://doi.org/10.1007/s12471-017-1021-0
  8. Asfalou I, Boumaaz M, Raissouni M, Sabry M, Benyass A, Zbir EM. Huge left atrial appendage aneurysm revealed by chronic hiccups. J Saudi Heart Assoc 2017;29:293-296 https://doi.org/10.1016/j.jsha.2017.03.009
  9. Ma J, Chen Q, Ma S. Left atrial fibrosis in atrial fibrillation: mechanisms, clinical evaluation and manage-ment. J Cell Mol Med 2021;25:2764-2775 https://doi.org/10.1111/jcmm.16350
  10. Henningsson M, Malik S, Botnar R, Castellanos D, Hussain T, Leiner T. Black-blood contrast in cardiovascular MRI. J Magn Reson Imaging 2020;55:61-80 https://doi.org/10.1002/jmri.27399