Cerebral Emboli from Aneurysm of Left Atrial Appendage

Congenital Left Atrial Appendage Aneurysm: A Case Report and Brief Review of Literature

“…Freedom from atrial arrhythmias has been reported from 6 months to 8 years after aneurysmectomy [1][2][3][4][5][6][7][8][9][10][11][12]. Our patient had intermittent episodes of supraventricular arrhythmias and was treated by excision of the atrial appendage aneurysm.…”

“…Physical examination is often unrevealing [1][2][3][4][5][6][7][8][9][10][11][12]. An ECG and a 24-h holter study should be performed [1][2][3][4][5][6][7][8][9][10][11][12]. A chest roentogenogram may show a non-specific cardiomegaly with an unusually prominent left heart border [13].…”

“…Till date, there is no non-invasive or invasive investigation, which conclusively demonstrates the pericardial defect and differentiates between intra-and extra-pericardial types. Only during surgery or following autopsy can a true intrapericardial left atrial aneurysm be diagnosed [1][2][3][4][5][6][7][8][9][10][11][12].…”

“…Surgical excision of the LA appendage addresses the issue of intra-aneurysmal thrombi and is sufficient in eliminating atrial tachyarrhythmias in most patients [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. Use of the extracorporeal circulation via median sternotomy is the widely accepted approach, uniformly considered safer and successful especially in giant LAAA with intraaneurysmal thrombi.…”

“…Use of the extracorporeal circulation via median sternotomy is the widely accepted approach, uniformly considered safer and successful especially in giant LAAA with intraaneurysmal thrombi. It provides a safety excision in a motionless field and precludes embolisation [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][19][20][21][22][23]. Despite the report of some investigators [24,25] on the use of left lateral thoracotomy without CPB and by Burke and associates [9] on stapling of the aneurysm, we consider these techniques as risky procedures.…”