Planning and execution of catheter closure of a giant left atrial appendage aneurysm causing recurrent cardioembolism

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Abstract

Giant left atrial appendage aneurysms (LAAAs) are rare causes of recurrent cardioembolism and managed routinely by surgery. A first catheter closure of a giant LAAA is reported, when a recent cerebral infarct precluded immediate surgery. Planning included ostial measurement on multimodal imaging, echo navigation for septal puncture, rotational angiogram for profiling, overlay imaging for device placement, and cerebral embolic protection from thrombus debris.

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Most cited references 8

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Congenital left atrial appendage aneurysm: a case report and brief review of literature.

Ujjwal Chowdhury, Sandeep Seth, Raghu Govindappa … (2009)

A 28-year-old woman with congenital aneurysm of the left atrial appendage was successfully treated by aneurysmectomy and is reported for its rarity. The exact diagnosis is relatively easy to make by contrast echocardiography, magnetic resonance imaging, and/or computerised tomographic angiography, provided the possibility is entertained. Because of supraventricular arrhythmias and systemic thromboembolism, surgical resection was deemed the best curative option to avoid further episodes and recurrence. Published reports detailing the diagnostic evaluation and surgical management for congenital left atrial appendage aneurysm are also discussed.

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Congenital aneurysms of the left atrium: recognition by cross-sectional echocardiography.

L Gillam, D Guyer, Brant C. Gibson … (1982)

The two-dimensional echocardiographic features of three patients with congenital aneurysms of the left atrium are described. The aneurysm arose from the left atrial appendage in two patients and from the posterior left atrial wall in one. The aneurysms were characterized by their origin from an otherwise normal left atrium, a well-defined neck, their position within the pericardial space, and distortion of the left ventricular free wall by the aneurysmal body. The differentiation of these structures from other abnormalities of the left atrium are also discussed. Two-dimensional echocardiography is a safe and reliable method for diagnosing congenital aneurysm of the left atrium, and such studies should be considered in any patient with an otherwise unexplained abnormality on the chest radiograph.

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Congenital left atrial appendage aneurysm diagnosed by fetal echocardiography.

Min Cho, Ji-Ae Park, Hyoung Doo Lee … (2010)

A newborn infant was evaluated because of a large cystic mass adjacent to the left atrium on prenatal ultrasound. The diagnosis was an aneurysm of the left atrial appendage. Most cases of this rare lesion are recognized between the 2nd and 4th decades of life. The present case, however, was detected on fetal echocardiography. The patient showed significant mitral regurgitation caused by the compression of the left atrioventricular groove. Simple aneurysmectomy without mitral valvuloplasty was sufficient to relieve significant mitral regurgitation in this case.

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Author and article information

Journal

Journal ID (nlm-ta): Ann Pediatr Cardiol

Journal ID (iso-abbrev): Ann Pediatr Cardiol

Journal ID (publisher-id): APC

Title: Annals of Pediatric Cardiology

Publisher: Wolters Kluwer - Medknow (India )

ISSN (Print): 0974-2069

ISSN (Electronic): 0974-5149

Publication date (Print): Oct-Dec 2020

Publication date (Electronic): 17 September 2020

Volume: 13

Issue: 4

Pages: 353-356

Affiliations

[1]Department of Pediatric Cardiology, Madras Medical Mission, Chennai, Tamil Nadu, India

Author notes

Address for correspondence: Dr. Sivakumar Kothandam, Department of Pediatric Cardiology, Institute of Cardio Vascular Diseases, Madras Medical Mission, 4A, Dr. J J Nagar, Mogappair, Chennai - 600 037, Tamil Nadu, India. E-mail: drkumarsiva@ 123456hotmail.com

Article

Publisher ID: APC-13-353

DOI: 10.4103/apc.APC_76_20

PMC ID: 7727907

PubMed ID: 33311928

SO-VID: 96c22310-9245-46ea-ac21-f0de317f11eb

License:

This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

History

Date received : 18 April 2020

Date revision received : 27 June 2020

Date accepted : 27 July 2020

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