Project description:Right atrial appendage aneurysms (RAAAs) are rarely encountered. If symptomatic, they present with atrial arrhythmias or embolic events. Surgical resection is indicated for symptomatic patients. We describe a 65-year-old man presenting with palpitation for 6 months. Electrocardiogram showed atrial flutter. Transthoracic echocardiography revealed a large thin-walled cystic mass anterior to right ventricular outflow tract, which was confirmed to be a giant RAAA by contrast transoesophageal echocardiography and later by contrast-enhanced computerised tomography. The patient underwent electrocardioversion, following which he remained in sinus rhythm and was asymptomatic during the 3 months follow-up period.RAAA can present with atrial flutter.Transoesophageal contrast echocardiography is the most valuable non-invasive tool in diagnosis of RAAA.Although computed tomography scan is not necessary for establishing the diagnosis, it may provide useful information regarding the structural anatomy.
Project description:A gigantic right atrial appendage aneurysm (RAAA) is a rare condition usually discovered during the third decade of life after being symptomatic. We present an asymptomatic RAAA discovered early during the basic screening of an infant and its natural history, and a ten-year follow-up due to its parents being against operation.
Project description:Left atrial appendage aneurysm (LAAA) is a rare cardiac anomaly that is usually incidentally found in middle-aged patients. Though initially asymptomatic, LAAA can cause some serious complications: atrial tachyarrhythmia, thromboembolism, peripheral compression, and cardiac dysfunction. Multimodal imaging technologies, especially echocardiography and computed tomography (CT) scanning play an important role in the diagnosis of LAAA. Transthoracic echocardiography (TTE) is generally used for preliminary evaluation and diagnosis of the aneurysm. CT scanning can further confirm the diagnosis by demonstrating the spatial structure relationships and eliminating the possibility of other cardiac tumors. The following case study pertains to a 54-year-old patient with recurrent chest tightness and atrial tachycardia. The patient was diagnosed with a giant LAAA by multimodal imaging technology, and the aneurysm was surgically removed under cardiopulmonary bypass. After 4 years of follow-up, the patient reported living a healthy life without chest discomfort, complications, or medication. Multimodal imaging can provide important information for the diagnosis and treatment of left atrial appendage aneurysms, and aneurysm resection can be an effective therapeutic approach with a good long-term prognosis.
Project description:In this case report, a 33-year-old male with a history of smoking presented with recurrent palpitations and chest discomfort. Holter monitoring revealed atrial flutter, and imaging showed a giant left atrial appendage aneurysm. Due to the risk of arrhythmias and thromboembolic events, surgical resection was performed successfully. This case underscores the importance of considering uncommon structural cardiac abnormalities in the evaluation of arrhythmia symptoms in young patients.
Project description:PurposeUnderstanding of the atrial fibrillation (AF) driven by right atrial appendage (RAA) is limited. This study aimed to understand the characteristics of the AF driven by RAA and explore ablation methods.MethodsThis was a retrospective study and patients who were identified as having the AF driven by RAA were reviewed. Ablation was performed during AF. Potential maps of the left and right atrium, electrophysiological examinations, and ablation methods were studied.ResultsAmong the 20 identified patients (mean age 67.0 ± 11.2 years; ejection fraction 62.9 ± 6.0%; LA diameter 43.1 ± 4.9 mm; RA diameter 51.7 ± 8.3 × 42.9 ± 3.7 mm), the AF cycle length in RAA (134.0 ± 10.9 ms) was the shortest, and the fastest frequency potentials were located in the RAA in 65% of patients. For the left atrium, the AF cycle length of the roof (145.5 ± 14.9 ms) was the shortest, followed by the left atrial appendage (153.7 ± 17.1 ms) and bottom (154.8 ± 11.8 ms). High-frequency potentials of RAA could be rapidly conducted to left atrium via sagittal bundle and Bachmann's bundle, and the conduction time (55.0 ± 5.0 ms) was significantly shorter than the mean bi-atrial activation time (176.7 ± 10.3 ms, P < 0.0001). AF could be terminated after ablation at the RAA base (17 patients) or mechanical stimulation within the RAA (3 patients). To date, only two patients had recurrent atrial flutter, while the remaining patients maintained sinus rhythm.ConclusionThe AF driven by RAA is characterized by high-frequency potentials in RAA, and ablation at the RAA base can achieve a satisfactory therapeutic effect.
Project description:A right atrial (RA) mass was incidentally found by transthoracic echocardiography in a 79-year-old man with atrial fibrillation rhythms but without a history of anticoagulation. Transesophageal echocardiography revealed a pedunculated immobile mass in the RA appendage. In addition, some calcification was detected in computed tomography. The mass was excised, and pathological examinations revealed organized thrombosis. Accordingly, in the presence of predisposing factors, thrombi, which may mimic some imaging features of tumors, should be considered in the differential diagnosis of RA masses.