Surgical treatment of atrial septum lipomatous hypertrophy associated with syncopal attacks

Abstract

Lipomatous hypertrophy of atrial septum (LHAS) is a rare benign cardiac condition characterized by fatty tissue infiltration located in the atrial septum. We presented a rare case of LHAS resulting in recurrent syncopal attacks.

Incidental Finding of Lipomatous Hypertrophy of the Right Atrial Free Wall in an Elderly Female With Severe Pulmonary Hypertension: Early Detection by Multimodality Imaging

“…A great majority of patients with LAH are asymptomatic, and LAH is discovered incidentally at TTE [ 9 ]; however, in some cases, this fatty infiltration can either cause intra-atrial conduction disturbances and atrial arrhythmias, or in case of severe LAH, patients may develop obstruction of RA filling, shortness of breath, and/or heart failure symptoms [ 10 , 11 ]. The surgical treatment of LAH should be limited only to cases of symptomatic patients with life-threatening cardiovascular complications [ 12 ].…”

“…The surgical treatment of LAH should be limited only to cases of symptomatic patients with life-threatening cardiovascular complications [12].…”

Lipomatous Hypertrophy of Interatrial Septum Presenting with Two Distinct Atrial Arrhythmias

“…It is unclear if AVNRT is related to the lipomatous infiltration process. Surgical resection and repair is warranted in cases of high risk or life-threatening symptoms and arrythmias [9]. Surgical resection can potentially result in termination of the arrythmia [2].…”

Increased 18F-PSMA and 18F-FDG Uptake in Lipomatous Hypertrophy of the Interatrial Septum

“…4,5 Although LHIS is a benign disorder and remains asymptomatic in the majority of cases, it rarely can cause atrial arrhythmias, obstructive flow symptoms, and sudden death. [6][7][8][9][10][11][12][13] Increased 18 F-FDG uptake in LHIS can occasionally be found on 18 F-FDG PET/CT, 14,15 initially thought to be caused by metabolic activation of brown adipose tissue. 16 There is no evidence of increased 18 F-FDG uptake in other brown adipose tissue in our patient, and this theory has also been questioned by some authors, suggesting inflammation or other unknown mechanism of increased 18 F-FDG uptake.…”

“…It has a prevalence of 1% in autopsy studies 2,3 and between 2.2% and 7.6% in imaging studies, depending on the modality (CT vs transesophageal echocardiography) 4,5 . Although LHIS is a benign disorder and remains asymptomatic in the majority of cases, it rarely can cause atrial arrhythmias, obstructive flow symptoms, and sudden death 6–13 . Increased 18 F-FDG uptake in LHIS can occasionally be found on 18 F-FDG PET/CT, 14,15 initially thought to be caused by metabolic activation of brown adipose tissue 16 .…”