Left atrial appendage aneurysm (LAAA) is a rare cardiac anomaly, the association with right ventricular diverticulum (RVD) is extremely rare. LAAA is characterized by aneurysmal dilatation of left atrial may be congenital or acquired RVD is an outpouching from the right cardiac chamber. Often fortuitous discovery between fetal period and adult age, these two entities are usually asymptomatic but can be complicated by arrythmia and thrombo- embolism. We report the case of a 22- years old which we have diagnosed LAAA associated with a RVD. The revelation mode was a pericardial effusion and the mechanism of pericardial effusion would be a pericardial dysgenesis or an inflammatory reaction.The diagnosis of these two anomalies is essentielly posed by imagery test especially cardiac echography, cardiac RMI and scan. Treatment consists of resection of LAAA and RVD with pericardiocentesis.

Amyloidosis refers to a group of systemic diseases whose common feature is the extracellular accumulation of insoluble fibrillar proteins in tissues (heart, reins, digestive tract). Several types of amyloidosis have been described; the primary (AL) and the secondary (AA) forms are by far the most frequent. AL amyloidosis is rare but not exceptional disease, with a prevalence of 500new cases per year in France. It is related to be precipitation in tissues of monoclonal light chains of immunoglobulin in the form of fibrils. Its diagnosis is histological based on the biopsy analysis of an affected organ or on non-invasive biopsies (subcutaneous fat, accessory salivary glands, etc) with the detection of amorphous deposits stained by congo red with dichroism and birefringence in polarised light, which is the reference examination. But the diagnostic approach can also be done by thioflavin staining which is very sensitive but not specific for amyloidosis and always requieres a diagnostic confirmation by congo red staining. We report the case of a patient with severe restrictive cardiomyopahy and presenting a set of paraclinical arguments specific for amyloidosis whose diagnosis was made by thioflavin staining.

In recent years, we have witnessed the emergence of minimally invasive techniques such as Transcatheter Aortic Valve Implantation (TAVI) for the management of aortic valve stenosis in the elderly or at high surgical risk. TAVI, although with a low mortality rate and a simpler procedural technique, is not free from complications, especially with associated coronary artery disease. Here we report a clinical case of an 83-year-old diabetic patient with atrial fibrillation under rivaroxaban, admitted to the Angoulême hospital center for left heart failure. After management of the left heart decompensation, a transthoracic echocardiography confirms a severe aortic valve stenosis for an aortic valve surface of 0.8 cm2 and a mean trans-aortic gradient of 46 mmHG with an LVEF of 40%. A pre-therapeutic coronarography shows a tri-truncal lesion including a significant stenosis of the proximal left anterior descending artery. In view of the age of this patient, and surgical risk, a TAVI was proposed while discussing the modalities and timing of coronary revascularization.