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

Abstract

BackgroundRight atrial appendage aneurysms are rare entities that may have significant clinical consequences. When co-existing with atrial fibrillation, patients are at risk of developing pulmonary or paradoxical systemic emboli.Case presentationAn elderly patient presented to medical attention with symptoms of acute diverticulitis. On abdominal computed tomography, a massively enlarged right atrial appendage aneurysm was discovered incidentally. The aneurysm caused marked compression of the right ventricle and contained an area of hypoenhancement concerning for an intraluminal thrombus. Gadolinium-enhanced cardiovascular magnetic resonance was performed and first-pass perfusion images demonstrated that the area of hypoenhancement was in fact poorly mixing blood. The patient was therefore managed medically.ConclusionRight atrial appendage aneurysms are infrequently encountered cardiac abnormalities. In the literature, surgery has been offered to patients who are young, symptomatic, or have evidence of thrombotic disease, although whether this practice pattern is associated with superior clinical outcomes is unclear. In the present case, gadolinium-enhanced cardiovascular magnetic resonance imaging was used to exclude the presence of intraluminal thrombus in an elderly patient, which helped orient the patient’s treating team towards medical—rather than surgical—therapy.Electronic supplementary materialThe online version of this article (10.1186/s13104-017-3046-2) contains supplementary material, which is available to authorized users.

Surgical repair of a giant congenital right atrial aneurysm concomitant with Wolff‐Parkinson‐White syndrome: A case report and literature review

“…While some cases are asymptomatic, a broad spectrum of symptoms, including supraventricular arrhythmias (even in the fetal period), 9 thrombus formation, chest pain, fatigue, dyspnea, and syncope have been reported. 4,7,[10][11][12] In our case, the patient presented with palpitation due to WPW, which is very rarely associated with a GRAA and only a few cases have been reported in the literature. 13,14 Some experts have recommended using anticoagulants to prevent thrombus formation and administering anti-arrhythmic medications to prevent arrhythmic complications.…”

Fetal atrial appendage aneurysm: Prenatal diagnosis by echocardiography and prognosis

“…Computed tomography and cardiac magnetic resonance imaging are important complementary examinations after birth, which can provide more details on the neighboring structures of the aneurysm, especially when patients need to undergo surgery. 1,2,5,7 Congenital atrial appendage aneurysm may be isolated, or associated with other cardiac abnormalities. 1,16,17 About 6% of patients with left atrial appendage aneurysm have multiple variants of CHD, including atrial septal defect, ventricular septal defect, deformation of mitral valve, malformation of coronary artery, anomalous renal artery, and Noonan syndrome.…”

“…Prognoses after early interventions are favorable. 6,7 However, there are only limited cases of fetal atrial appendage aneurysm in literature and prognosis of those fetuses is still unknown. 1,8,9 In this study, we summarized our data of fetal atrial appendage aneurysm in our center to identify the echocardiographic characteristics and prognosis of those group.…”

A giant right atrial appendage aneurysm in an infant: a case report

“…6 However, there is no guideline for the treatment of this condition, and surgical resection is safe and can be performed through sternotomy with or without cardiopulmonary bypass for symptomatic patients. 2,5 Here, we reported an infant with a giant RAAA and severe symptoms who underwent surgical resection of the aneurysm.…”

“…2,4 Generally, patients with RAAA are usually asymptomatic and are diagnosed incidentally or until they present some clinical symptoms like arrhythmia or dyspnea. 5 Pulmonary thromboembolism is a common complication due to blood stasis in the aneurysm. 6 However, there is no guideline for the treatment of this condition, and surgical resection is safe and can be performed through sternotomy with or without cardiopulmonary bypass for symptomatic patients.…”