Giant right atrial aneurysm presenting as right heart failure

Abstract

Idiopathic aneurysmal dilatations of the right atrium are rare anomalies. We report one such case of a young man presenting with fatigue, abdominal distension, pedal oedema, unremarkable cardiac examination except for raised jugular venous pressure, an electrocardiogram showing normal sinus rhythm with right bundle-branch block, and an radiograph of the chest showing cardiomegaly. The echocardiographic examination revealed a giant right atrium with low pressure tricuspid regurgitation. The computed tomography confirmed the findings of two-dimensional echocardiography. He was put on medical treatment and remained symptomatically controlled on follow-up.

Surgical repair of a giant congenital right atrial aneurysm: a case report

“…RAA can be asymptomatic or it can present with a variety of symptoms including supraventricular arrhythmias, formation of intraatrial thrombus and severe atrial dilatation. The most common one is supraventricular arrhythmias such as atrial fibrillation [ 1 , 2 , 5 – 7 , 15 ]. It is not known why arrhythmias’ occur in such patients.…”

“…They also emphasize that patients with severe dilatation of the atrium and symptomatic patients should be treated surgically [ 12 ]. The main indications for surgery are: atrial arrhythmia, intraatrial thrombus formation, major atrial dilatation, and compression of other heart chambers [ 1 , 6 , 7 , 14 ]. Binder et al state that surgical resection of right atrial aneurysm has a low mortality risk [ 1 ].…”

“…reported 5 % of deaths associated with unoperated congenital enlargement of the right atrium [ 1 ]. Major risks related giant congenital right atrial aneurysms include supraventricular arrhythmias, thrombosis, and severe atrial dilatation [ 1 , 5 – 7 ]. In our article we present a rare case of this anomaly presenting as a tamponade, which we treated with and an complex aneurysmectomy complicated by an unexpected anatomical anomalyof the right coronary artery.…”

Pediatric Giant Right Atrial Aneurysm: A Case Series and Review of the Literature

“…The procedure has since been used in both adult and pediatric GRAA patients. Pediatric indications for atrial aneurysm resection include atrial arrhythmias, intracavitary thrombus, major atrial dilatation, and right ventricular compression . The procedure has a low operative mortality rate and can be completed with or without cardiopulmonary bypass .…”

“…Pediatric indications for atrial aneurysm resection include atrial arrhythmias, 4,17 intracavitary thrombus, 2,3 major atrial dilatation, and right ventricular compression. 13,14,18 The procedure has a low operative mortality rate and can be completed with or without cardiopulmonary bypass. 3 All of the presented cases were completed with cardiopulmonary bypass.…”