• Investigative Magnetic Resonance Imaging
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• v.20 no.2
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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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• v.51 no.2
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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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• v.32 no.9
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• pp.827-830
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• 1999

Congenital left atrial appendage aneurysm is a very rare congenital cardiac abnormality. That is postulated to arise from a developmental weakness in the atrial wall in utero. Clinically, patients are often asymptomatic and are diagnosed incidentally, but supraventricular arrhythmias and systemic thromboembolism have also been reported in some cases. Surgical resection at the time of diagnosis is recommended because of the propensity for thromboembolic complications. A 13-month-old female, who was suspected preoperatively as having partial absence of pericardium with left atrial herniation through the defect, underwent surgical resection of the left atrial appendage aneurysm. Exposure through a median sternotomy showed an intact pericardium. The postoperative course was uneventful.

• Journal of Chest Surgery
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• v.42 no.2
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• pp.244-247
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• 2009

A left atrial appendage aneurysm is a very rare medical condition which can develop by an inflammatory reaction or a degenerative change. If there is no accompanying anomaly, a left atrial appendage is considered a congenital disease. The majority of left atrial appendage aneurysms are detected incidentally because they usually do not cause any symptoms. Surgery is indicated, even for asymptomatic patients, because of the risk of life-threatening complications, such as atrial fibrillation, supraventricular tachycardia, systemic embolization, and cardiac arrest. Left atrial appendage aneurysms are usually treated by a median sternotomy with extracorporeal circulation, especially if the aneurysm has a broad base or contains a thrombus, but can treated by thoracotomy without extracorporeal circulation. We report a case of a successfully treated left atrial appendage aneurysm that was misdiagnosed as a partial pericardial defect without extracorporeal circulation in a 13-year old child.

• Journal of the Korean Society of Radiology
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• v.83 no.6
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• pp.1400-1405
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• 2022

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.

• Journal of Chest Surgery
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• v.41 no.5
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• pp.643-646
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• 2008

Congenital intrapericardial left atrial appendage aneurysms (LAAA) are very rare. Most cases are asymptomatic and this malady is generally incidentally diagnosed in older patients. LAAAs are usually accompanied with supraventricular arrhythmias and life-threatening systemic embolism. Complete surgical correction is recommended immediately after the diagnosis to prevent significant complications, and even for the asymptomatic patients. We report here on the case of a 45-year-old man who presented with cerebral embolism due to LAAA. The patient was successfully treated with a resection of the aneurysm.