Asymptomatic giant congenital left atrial aneurysm

Abstract

Congenital aneurysm of the left atrial appendage can be caused by congenital dysplasia of the pectinate muscles and may be accompanied by a congenital absence of the pericardium. Symptoms generally manifest after two decades and the most common symptom is atrial arrhythmia in the form of atrial fibrillation / flutter. A four year-old patient with no symptoms underwent an echocardiographic examination for the investigation of a heart murmur. Echocardiographic examination revealed a large cystic lesion occupying the left hemithorax and compressing the left ventricle. The patient was referred to our center. The lesion caused displacement of the heart rightward behind the sternum which made the examination difficult. We aimed to present this rare case of giant left atrial appendage aneurysm in the light of current literature.

Huge Left Atrial Appendage Aneurysm: A Case Report and Review of the Literature

“…LAAA often occurs in the left atrial appendage and the posterior wall of the left atrium, but more especially in the left atrial appendage. The specific cause remains unclear, but it may probably be due to atrial dysplasia and progressive dilatation as a result of intracardiac pressure [6] . LAAA is usually asymptomatic in children but may manifest as multiple symptoms such as palpitations, dyspnea and chest pain in adults, which are accidentally discovered or diagnosed when thrombosis, tachycardia or arrhythmia occur [6] .…”

Case Report: Giant Congenital Left Atrial Appendage Aneurysm Presenting With Acute Massive Cerebral Infarction and Refractory Atrial Fibrillation: A Case Report and Literature Review

“…Congenital LAAA was firstly described in two children by Dr. Parmley in 1962 ( 19 ). Most studies about LAAA are individual case reports ( 4 , 8 , 13 ), and to date, about 150 cases of this defect have been reported in the literature ( 7 , 10 , 20 ). Although this disease is rare, its consequences are potentially hazardous and late diagnosis is common.…”

“…Congenital LAAAs are caused by dysplasia of pectinate muscles in the appendage ( 3 ). A lot of LAAAs were asymptomatic and were discovered incidentally during echocardiographic exams ( 4 , 5 ). Others developed symptoms or signs after the second to third decade of life, such as palpitations, chest pain, dyspnea on exertion, and atrial tachyarrhythmia ( 6 – 9 ).…”

Surgical repair of a giant congenital left atrial aneurysm presenting with respiratory distress in a neonate

“…Congenital left atrial aneurysm is a very rare entity in neonates with 70% of cases being left atrial appendage aneurysms, and the remainder are left atrial aneurysms 1 . In neonates and infants, the early presentations of the lesion may be attributed to the secondary MR and airway obstruction, and the risk of complications increases with increase in its size 8 . To the best of our knowledge, there are only four reported cases of neonatal surgical management of CLAA (one was LA aneurysm, and three were LA appendage aneurysms).…”