• Journal of Chest Surgery
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• 제13권4호
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• pp.448-454
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• 1980

The juxtaposition of atrial appendage may possibly be diagnosed by angiography recently, and it is widely regarded as an ominous sign of severe cyanotic congenital heart disease. However, it is apparently rare congenital cardiac anomaly in which the atrial appendages lie side by side, both to the left or right of the great arteries, known as left or right juxtaposition of the atrial appendages. Juxtaposition of the atrial appendages has no functional significance, since it does not, itself, cause any hemodynamic disturbance. But it`s presence always indicates the coexistence of other major cardiac anomalies. In review of literatures TGA and VSD are invariable present, and ASD is common. Other anomalies, such as, tricuspid atresia, pulmonary outflow that, obstruction bicuspid pulmonic valve, persistent SVC etc. are relatively high incidence. In this report, we present one case of 6 year old female child having left juxtaposition of atrial appendage combined with TGA [D-looping, D-transposition], TAPVD, large ASD, small VSD, and vertical vein.

• Journal of Chest Surgery
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• 제48권6호
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• pp.429-431
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• 2015

Congenital pericardial defects (CPDs) are infrequent anomalies that are usually asymptomatic and are discovered incidentally during unrelated interventions. Here we report the case of a CPD with herniation of an enlarged left atrial appendage identified during total thoracoscopic ablation (TTA) for persistent atrial fibrillation (AF). The persistent AF was successfully treated with a hybrid procedure, in which TTA was followed by an electrophysiological study.

• Korean Journal of Radiology
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• 제22권4호
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• pp.525-534
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• 2021

Objective: To assess the effect of left atrial appendage (LAA) isolation on LAA emptying and left atrial (LA) function using cardiac MRI in patients who underwent successful catheter ablation of atrial fibrillation (AF). Materials and Methods: This retrospective study included 84 patients (mean age, 59 ± 10 years; 67 males) who underwent cardiac MRI after successful catheter ablation of AF. According to the electrical activity of LAA after catheter ablation, patients showed either LAA isolation or LAA normal activity. The LAA emptying phase (LAA-EP, in the systolic phase [SP] or diastolic phase), LAA emptying flux (LAA-EF, mL/s), and LA ejection fraction (LAEF, %) were evaluated by cardiac MRI. Results: Of the 84 patients, 61 (73%) and 23 (27%) patients showed LAA normal activity and LAA isolation, respectively. Incidence of LAA emptying in SP was significantly higher in LAA isolation (91% vs. 0%, p < 0.001) than in LAA normal activation. LAA-EF was significantly lower in LAA isolation (40.1 ± 16.2 mL/s vs. 80.2 ± 25.1 mL/s, p < 0.001) than in LAA normal activity. Furthermore, LAEF was significantly lower in LAA isolation (23.7% ± 11.2% vs. 31.1% ± 16.6%, p = 0.04) than in LAA normal activity. Multivariate analysis demonstrated that the LAA-EP was independent from LAEF (p = 0.01). Conclusion: LAA emptying in SP may be a critical characteristic of LAA isolation, and it may adversely affect the LAEF after catheter ablation of AF.

• Journal of Chest Surgery
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• 제32권9호
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• pp.827-830
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• 1999

선천성 좌심방이류는 매우 드물게 보는 선천성 심질환으로서, 태생기의 심장 혈성과정에서 좌심방벽이 박 약할 때에 발생되는 것으로 추측하고 있다. 임상적으로 환자들은 별다른 증상 없이 지내다가 우연한 기 맙\ulcorner진단이 되는 경우가 흔하지만, 상실성 부정맥과 전신성 혈전색전증의 소견을 보이는 예들도 있다. 진단이 되 면 곧 수술을 시행하여야 하는데, 그 이유는 혈전색전증이 발생할 가능성이 있기 때문이다. 경북대학교병원 흉부외과에서는 술전에 좌측심낭막의 부분결손에 따른 좌심방탈출증으로 추정하여 정중흉골절개하에 수술 을 시행하였던 생후 13개월된 여아에서 심낭막은 온전하였던 반면에 선천성 좌심방이류가 있음이 확인되어 이를 절제하는 수술을 시행하였다. 환아는 술후에 양호한 경과를 보였다.

• Investigative Magnetic Resonance Imaging
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• 제20권2호
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• pp.132-135
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• 2016

We report the case of a 43-year-old male with both giant left atrial appendage (LAA) aneurysm and drug-refractory atrial fibrillation (AF). The patient was treated with percutaneous electrical isolation of cardiac arrhythmogenic substrate, and has been free of AF symptom over one year. Although the surgical resection of giant LAA aneurysm is mostly used to prevent systemic thromboembolism, we have performed follow-up of the giant LAA aneurysm using cardiac magnetic resonance (CMR) imaging and transesophageal echocardiography (TEE) after the successful catheter ablation of refractory AF. At one-year follow-up CMR, the giant LAA aneurysm showed remarkable enlargement as well as decreased contractility. Additionally, one-year follow-up TEE showed spontaneous echo contrast as an indicator of blood stasis in the giant LAA aneurysm. Those findings of giant LAA aneurysm suggest that the risk of thromboembolism may be high despite termination of AF.

• Journal of Chest Surgery
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• 제42권2호
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• pp.244-247
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• 2009

좌심방 부속지류는 매우 드문 질환으로 염증반응이나 퇴행성 변화로 발생할 수 있지만, 동반된 다른 기형이 없을 경우 선천성으로 생각할 수 있다. 선천성 좌심방 부속지류는 대부분 증상이 없어 우연히 발견되지만, 심방 세동, 상심실성 빈맥, 전신 색전증상, 심정지 등 합병증이 발생할 수 있어 진단되면 증상이 없어도 수술을 권장하고 있다. 개흉술을 통해 접근이 가능하지만, 기저부가 넓은 경우나 좌심방 부속지내에 혈전이 있는 경우에는 체외순환이 필요해 정중흉골 절개술이 필요할 수 있다. 저자들은 부분 심낭 결손증으로 오인되었던 선천성 좌심방 부속지류를 좌측 개흉술을 통해 체외순환 없이 성공적으로 수술하였기에 증례 보고를 하는 바이다.

• Journal of Chest Surgery
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• 제51권2호
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• pp.146-148
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• 2018

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.

• Journal of Chest Surgery
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• 제23권6호
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• pp.1280-1287
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• 1990

A seven month old female infant with isolated ventricular inversion and anatomically corrected malposition of the great arteries in situs solitus, associated with ventricular septal defect, patent ductus arteriosus, right-sided juxtaposition of left atrial appendage, is reported. The patient showed usual atrial arrangement with somewhat superoinferior relation, a discordant atrioventricular connection, and a concordant ventriculoarterial connection with aorta in the right-sided position. A normal sized left atrium was connected to the left superiorly positioned morphologic right ventricle through a tricuspid valve, which crossed the left ventricular outflow tract anteriorly. Well developed bilateral[subaortic and sub-pulmonary]conus was documented at operative field. successful surgical repair was done by performing the Senning procedure and by closing the ventricular sepal defect with a patch through the right ventriculotomy. The infant’s postoperative course was uneventful with normal sinus rhythm. Postoperative cardiac catheterization revealed no hemodynamic obstruction or residual shunt.

• 대한영상의학회지
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• 제83권6호
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• pp.1400-1405
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• 2022

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.

• Journal of Chest Surgery
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• 제21권5호
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• pp.948-953
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• 1988

A technique applicated for physiologic correction of complex congenital cardiac disease suitable for Fontan procedure in which drainage of left superior vena cava and hepatocardiac vein to left atrium combined is described. We made one systemic venous baffle from left hepatocardiac vein to left superior vena cava and another systemic venous baffle from right inferior vena cava to the right superior vena cava with rigid prosthetic material[0.5mm thickness PTFE patch]. And then we anastomosed directly between the right sided atrial appendage and right pulmonary artery, and left-sided atrial wall beneath the appendage and left pulmonary artery. We believe that this procedure is superior to the method using intraatrial tube graft to divert the left hepatocardiac venous blood to right atrium, and applicable for physiologic correction of any complex congenital cardiac disease suitable for Fontan-type procedure in which anomalies of systemic venous drainage combined.