Accessory Liver in the Right Atrium: A Rare Cause of Syncope

Abstract

This report highlights the first case of complete resection of an accessory liver found embedded in the right atrium obstructing venous return to the heart, acutely reducing cardiac output, and producing recurrent syncopal episodes.

Recurrent Cardiogenic Syncope From Extrinsic Organ Anomaly

“…8 There was modest female preponderance in this population (female, 67% 2,6,7,9 ; male, 33% 5,8 ). Forest et al 8 reported the largest AHL with a maximum diameter of 3 cm. At a maximum diameter of 4 cm, the case described herein represents the largest AHL reported to date.…”

“…There are only six other reported cases of this particular type of AHL. 2,[5][6][7][8][9] Patient ages have ranged from 12 years 5 to 69 years. 8 There was modest female preponderance in this population (female, 67% 2,6,7,9 ; male, 33% 5,8 ).…”

“…2,[5][6][7][8][9] Patient ages have ranged from 12 years 5 to 69 years. 8 There was modest female preponderance in this population (female, 67% 2,6,7,9 ; male, 33% 5,8 ). Forest et al 8 reported the largest AHL with a maximum diameter of 3 cm.…”

Recurrent Cardiogenic Syncope From Extrinsic Organ Anomaly

“…8 There was modest female preponderance in this population (female, 67% 2,6,7,9 ; male, 33% 5,8 ). Forest et al 8 reported the largest AHL with a maximum diameter of 3 cm. At a maximum diameter of 4 cm, the case described herein represents the largest AHL reported to date.…”

“…There are only six other reported cases of this particular type of AHL. 2,[5][6][7][8][9] Patient ages have ranged from 12 years 5 to 69 years. 8 There was modest female preponderance in this population (female, 67% 2,6,7,9 ; male, 33% 5,8 ).…”

“…2,[5][6][7][8][9] Patient ages have ranged from 12 years 5 to 69 years. 8 There was modest female preponderance in this population (female, 67% 2,6,7,9 ; male, 33% 5,8 ). Forest et al 8 reported the largest AHL with a maximum diameter of 3 cm.…”

Commentary: A rare intracaval mass with intracardiac extension: A value of frozen section revisited?

“…In the majority of them, AHT was accidentally found in the RA mimicking the clinical course of atrial myxoma. [2][3][4][5] There is no uniform theory explaining the incidence of AHT within the heart chambers. Clearly, there has to be a hematogenous spread of hepatic cells with regenerative potential to the heart chambers, and in the absence of trauma, the embryological explanation of this phenomenon is the most attractive.…”

“…A similar approach with the use of DHCA for the resection of AHL has been reported by Forest and colleagues. 4 Use of DHCA seems to be a logical and valuable option providing a blood-free surgical field in the area of the RA-IVC junction, which helps to delineate the entire anatomy of the AHL. On the other hand, femoral cannulation, with the IVC cannula positioned just inferior to the retro-hepatic IVC, may provide sufficient IVC drainage to accomplish AHL resection without DHCA.…”

Recurrent Cardiogenic Syncope From Extrinsic Organ Anomaly

“…8 There was modest female preponderance in this population (female, 67% 2,6,7,9 ; male, 33% 5,8 ). Forest et al 8 reported the largest AHL with a maximum diameter of 3 cm. At a maximum diameter of 4 cm, the case described herein represents the largest AHL reported to date.…”

“…There are only six other reported cases of this particular type of AHL. 2,[5][6][7][8][9] Patient ages have ranged from 12 years 5 to 69 years. 8 There was modest female preponderance in this population (female, 67% 2,6,7,9 ; male, 33% 5,8 ).…”

“…2,[5][6][7][8][9] Patient ages have ranged from 12 years 5 to 69 years. 8 There was modest female preponderance in this population (female, 67% 2,6,7,9 ; male, 33% 5,8 ). Forest et al 8 reported the largest AHL with a maximum diameter of 3 cm.…”

Commentary: A rare intracaval mass with intracardiac extension: A value of frozen section revisited?

“…In the majority of them, AHT was accidentally found in the RA mimicking the clinical course of atrial myxoma. [2][3][4][5] There is no uniform theory explaining the incidence of AHT within the heart chambers. Clearly, there has to be a hematogenous spread of hepatic cells with regenerative potential to the heart chambers, and in the absence of trauma, the embryological explanation of this phenomenon is the most attractive.…”

“…A similar approach with the use of DHCA for the resection of AHL has been reported by Forest and colleagues. 4 Use of DHCA seems to be a logical and valuable option providing a blood-free surgical field in the area of the RA-IVC junction, which helps to delineate the entire anatomy of the AHL. On the other hand, femoral cannulation, with the IVC cannula positioned just inferior to the retro-hepatic IVC, may provide sufficient IVC drainage to accomplish AHL resection without DHCA.…”

Recurrent Cardiogenic Syncope From Extrinsic Organ Anomaly

“…8 There was modest female preponderance in this population (female, 67% 2,6,7,9 ; male, 33% 5,8 ). Forest et al 8 reported the largest AHL with a maximum diameter of 3 cm. At a maximum diameter of 4 cm, the case described herein represents the largest AHL reported to date.…”

“…There are only six other reported cases of this particular type of AHL. 2,[5][6][7][8][9] Patient ages have ranged from 12 years 5 to 69 years. 8 There was modest female preponderance in this population (female, 67% 2,6,7,9 ; male, 33% 5,8 ).…”

“…2,[5][6][7][8][9] Patient ages have ranged from 12 years 5 to 69 years. 8 There was modest female preponderance in this population (female, 67% 2,6,7,9 ; male, 33% 5,8 ). Forest et al 8 reported the largest AHL with a maximum diameter of 3 cm.…”

Commentary: A rare intracaval mass with intracardiac extension: A value of frozen section revisited?

“…In the majority of them, AHT was accidentally found in the RA mimicking the clinical course of atrial myxoma. [2][3][4][5] There is no uniform theory explaining the incidence of AHT within the heart chambers. Clearly, there has to be a hematogenous spread of hepatic cells with regenerative potential to the heart chambers, and in the absence of trauma, the embryological explanation of this phenomenon is the most attractive.…”

“…A similar approach with the use of DHCA for the resection of AHL has been reported by Forest and colleagues. 4 Use of DHCA seems to be a logical and valuable option providing a blood-free surgical field in the area of the RA-IVC junction, which helps to delineate the entire anatomy of the AHL. On the other hand, femoral cannulation, with the IVC cannula positioned just inferior to the retro-hepatic IVC, may provide sufficient IVC drainage to accomplish AHL resection without DHCA.…”