Surgical Treatment of Giant Left Atrial Diverticulum in an Adult

Qian, Lei; Guo, Huiming; Zhi-chao, Luo

doi:10.1016/j.athoracsur.2013.10.110

Cited by 4 publications

(3 citation statements)

References 6 publications

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“…Diagnosis with LA diverticulum can be delayed until adulthood because most of them are asymptomatic. Surgical resection of LA diverticulum was considered appropriate because of the patient’s symptom of compression and the risk of thrombosis and rupture [ 8 ]. LA diverticulum may be a source for ectopic arrhythmogenic foci [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Bleeding sites and treatment strategies for cardiac tamponade by catheter ablation requiring thoracotomy: risks of catheter ablation in patients with left atrial diverticulum

Mitsuishi,

Miura,

Nomura

et al. 2024

J Cardiothorac Surg

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Background There is insufficient information regarding the bleeding sites and surgical strategies of cardiac tamponade during catheter ablation for atrial fibrillation (AF). Case presentation Of the five patients with cardiac tamponade, three required surgical intervention and two required pericardiocentesis. In the first case of three cardiac tamponades requiring surgical intervention, considering that the peripheral route was used, the catecholamines did not reach the heart, and due to unstable vital signs, venoarterial extracorporeal membrane oxygenation (VA-ECMO) was inserted. No bleeding point was identified, but a thrombus had spread around the left atrium (LA) with diverticulum. Hemostasis was achieved with adhesives placed around the LA under on-pump beating. In the second case, pericardiocentesis was performed, but the patient showed heavy bleeding and unstable vital signs. Thus, VA-ECMO was inserted. Heavy bleeding was expected, and safety was enhanced by attaching a reservoir to the VA-ECMO. The bleeding point was found between the left upper pulmonary artery and LA under cardiac arrest to obtain a good surgical view for suturing repair. In the third case, the LA diverticulum was damaged. Pericardiocentesis resulted in stable vitals, but sustained bleeding was present. A bleeding point was found at the LA diverticulum, and suture repair under on-pump beating was performed. Conclusions When cardiac tamponade occured in any patient with LA diverticulum, treatment could not be completed with pericardiocentesis alone, and thoracotomy was likely to be necessary. If the bleeding point could be confirmed, suturing technique is a more reliable surgical strategy than adhesive alone that leads to pseudoaneurysm. If the bleeding point is unclear, it is important to confirm the occurrence of LA diverticulum using a preoperative CT, and if confirmed, cover it with adhesive due to a high possibility of diverticulum bleeding. The necessity of CPB should be determined based on whether these operations can be completed while maintaining vital stability.

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Section: Discussionmentioning

confidence: 99%

Bleeding sites and treatment strategies for cardiac tamponade by catheter ablation requiring thoracotomy: risks of catheter ablation in patients with left atrial diverticulum

Mitsuishi,

Miura,

Nomura

et al. 2024

J Cardiothorac Surg

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“…But Binder et al considered treatments only for symptomatic patients [Binder 2000]. Other management options that have been reported for such large diverticulum are anticoagulation with observation and heart transplantation [Lei 2014].…”

Section: Discussionmentioning

confidence: 99%

Treatment of Giant Left Atrial Diverticulum: A Case Report and Literature Review

Yan

2020

HSF

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“…Giant left atrial diverticulum has been described sporadically in several studies and case reports, in most of which an isolated left atrial diverticulum resection was performed. Lei et al reported the case of an 18-year-old woman who presented with a 12 × 7 cm left atrial diverticulum, and the patient had an uneventful recovery after a surgical resection [Lei 2014]. Gao et al reported a 23-year-old female with a giant left atrium diverticulum (11 × 10 cm).…”

Section: Discussiomentioning

confidence: 99%

A Giant Left Atrial Diverticulum Diagnosed by Transesophageal Echocardiogram and Multidetector Computed Tomography: A Case Report and Brief Review of the Literature

Chen¹,

Cao²,

Zhang³

et al. 2017

HSF

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Giant left atrial diverticulum is a rare congenital malformation that is most commonly diagnosed in incidental finding. Here, we reported a case of a 1-year-old asymptomatic child with a giant left atrial diverticulum. Diagnosis was established by transthoracic echocardiography (TTE), and confirmed by multidetector computed tomography (MDCT) and transesophageal echocardiography (TEE). We excised the diverticulum and sewed its base under cardiopulmonary bypass and cardiac arrest. The patient had a good postoperative result.

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Surgical Treatment of Giant Left Atrial Diverticulum in an Adult

Cited by 4 publications

References 6 publications

Bleeding sites and treatment strategies for cardiac tamponade by catheter ablation requiring thoracotomy: risks of catheter ablation in patients with left atrial diverticulum

Bleeding sites and treatment strategies for cardiac tamponade by catheter ablation requiring thoracotomy: risks of catheter ablation in patients with left atrial diverticulum

Treatment of Giant Left Atrial Diverticulum: A Case Report and Literature Review

A Giant Left Atrial Diverticulum Diagnosed by Transesophageal Echocardiogram and Multidetector Computed Tomography: A Case Report and Brief Review of the Literature

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