Prenatal Diagnosis of an Aneurysm of the Right Atrium

Abstract

Congenital aneurysm of the right atrium was diagnosed in a 17‐week fetus. It appeared as an outward bulge of the right atrium which doubled its size. The aneurysm was akinetic. Flow across the atrioventricular valves appeared unobstructed. The fetus had no evidence of cardiac failure. The patient elected to terminate the pregnancy. Autopsy results were confirmatory.

Prenatal diagnosis of a fetal left atrial diverticulum

“…Single cases of congenital aneurysms of the left atrial appendage and diverticulum and aneurysm of the right atrium and the left ventricle have been described (Gold et al, 1996). Some of them were asymptomatic (Gembruch et al, 1990;Jacobson et al, 1991;Cavalle-Garrido et al, 1997;Gross et al, 1996), others caused heart rhythm disturbances (Shah and Walsh, 1992;Campbell et al, 1992) or pericardial effusion (Sepulveda et al, 1996;Johnson et al, 1996). It should be pointed out that in our case the diverticulum was asymptomatic, without any other structural anomalies of the heart.…”

Aneurysm of the Right Atrial Appendage

“…One patient had a recurring pulmonary embolism 10 , was treated with oral anticoagulation, and remained asymptomatic for more than 4 years, when the case was published. One patient was diagnosed in the prenatal period, and gestation was interrupted 12 . The remaining 3 cases had incessant atrial arrhythmias (1 fibrillation, 1 flutter and 1 atrial tachycardia).…”

Prenatal diagnosis and outcome of a ruptured aneurysm arising from the left atrium

“…The cases of fetal atrial aneurysms in the literature report diverticula arising from either the atrial septum 3,4 or from the remainder of the atrial wall 5,6 . However, abnormalities arising in the atrial septum may represent normal variations of closure of the foramen ovale 3 .…”

“…Such lesions arise most commonly from the ventricles. However, a few reports have documented cases emanating from an atrial chamber [3][4][5][6] . Adverse outcomes in these cases have been associated with the size of the aneurysm, the area of cardiac hypokinesis, and the presence of fetal hydrops due to low output failure.…”