Neonatal Management of a Giant Right Atrial Appendage Aneurysm

Abstract

The online-only Data Supplement is available with this article at http://circ.ahajournals.org/lookup/suppl

Use of cardiovascular magnetic resonance in the evaluation of a giant right atrial appendage aneurysm: a case report and review of the literature

“…Echocardiography plays a particularly important role in the pediatric population, where the radiation exposure of CT scans and the long scan times of CMR are of particular concern [ 9 ]. Indeed, agitated saline echocardiography has been used to differentiate RAA aneurysms from pericardial effusions in the neonate [ 7 ] and fetal ultrasound has been used to detect RAA aneurysms in the prenatal period [ 2 , 9 , 16 ]. Compared to CT and CMR, however, echocardiography has a poorer ability to differentiate RAA aneurysms from similarly-appearing anomalies [ 4 ] such as pericardial cysts [ 6 ], Ebstein’s anomaly [ 9 ], cor triatriatum [ 8 ], epicardial and pericardial fat lesions, and coronary aneurysms.…”

“…Less frequently encountered findings are outlined in Table 1 . While RAA aneurysms have been found in patients with atrial septal defects [ 7 , 10 , 12 , 13 , 16 ], ventricular septal defects, spontaneous pneumothoraces [ 12 ], left atrial appendage aneurysms, and tricuspid/mitral regurgitation [ 11 ], there is currently no clear etiological relationship between RAA aneurysms and these pathologies.…”

Right Atrial Appendage Aneurysm in a Newborn Diagnosed with Fetal Echocardiography

“…Clinical manifestation is in the range from asymptomatic condition to arrhythmia and repetitive pulmonary embolism [ 4 , 5 ]. Asymptomatic conditions can be diagnosed prenatally or incidentally [ 1 , 6 ]. Even though the patient may be asymptomatic, it is essential to diagnose atrial appendage aneurysm because of its complications [ 6 ].…”

“…Asymptomatic conditions can be diagnosed prenatally or incidentally [ 1 , 6 ]. Even though the patient may be asymptomatic, it is essential to diagnose atrial appendage aneurysm because of its complications [ 6 ].…”

“…For some cases in which surgery is not recommended, oral anticoagulant administration is necessary due to thromboembolic risk. Surgical approach can be necessary for progressive enlargement of RAA aneurysm or symptoms [ 6 , 8 ].…”