Belov DV, Moskalev VI, Garbuzenko DV, Arefyev NO. Left atrial appendage aneurysm: A case report. World J Clin Cases 2020; 8(19): 4443-4449 [PMID: 33083403 DOI: 10.12998/wjcc.v8.i19.4443]
Corresponding Author of This Article
Nikolay Olegovich Arefyev, MD, Academic Research, Surgeon, Department of Pathological Anatomy and Forensic Medicine, South Ural State Medical University, Vorovskogo 64, Chelyabinsk 454092, Russia. nikolai.arefyev@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 6, 2020; 8(19): 4443-4449 Published online Oct 6, 2020. doi: 10.12998/wjcc.v8.i19.4443
Left atrial appendage aneurysm: A case report
Dmitry Vladimirovich Belov, Vladimir Ivanovich Moskalev, Dmitry Victorovich Garbuzenko, Nikolay Olegovich Arefyev
Dmitry Vladimirovich Belov, Department of Hospital Surgery, South Ural State Medical University, Chelyabinsk 454092, Russia
Dmitry Vladimirovich Belov, Vladimir Ivanovich Moskalev, Department of Hospital Surgery, Federal Center for Cardiovascular Surgery, Chelyabinsk 454033, Russia
Dmitry Victorovich Garbuzenko, Department of Faculty Surgery, South Ural State Medical University, Chelyabinsk 454092, Russia
Nikolay Olegovich Arefyev, Department of Pathological Anatomy and Forensic Medicine, South Ural State Medical University, Chelyabinsk 454092, Russia
Author contributions: Belov DV and Moskalev VI collected the data, reviewed the literature and contributed to manuscript drafting; Garbuzenko DV contributed to manuscript drafting and revised manuscript for important intellectual content; Arefyev NO drafted the manuscript and reviewed the literature; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Nikolay Olegovich Arefyev, MD, Academic Research, Surgeon, Department of Pathological Anatomy and Forensic Medicine, South Ural State Medical University, Vorovskogo 64, Chelyabinsk 454092, Russia. nikolai.arefyev@gmail.com
Received: May 16, 2020 Peer-review started: May 16, 2020 First decision: June 7, 2020 Revised: June 8, 2020 Accepted: September 10, 2020 Article in press: September 10, 2020 Published online: October 6, 2020
Abstract
BACKGROUND
An aneurysm of the left atrial appendage is one of the rare but potentially hazardous heart defects. The risk of lethal complications grows with its size. To date, about 150 cases of this defect have been described in the literature. We present a case of left atrial appendage aneurysm with the deformation of the mitral valve and the left main coronary and circumflex artery, which required mitral valve annuloplasty and bifurcation stenting.
CASE SUMMARY
A 58-year-old man presented to our hospital complaining of shortness of breath, general weakness, dizziness during physical exertion, and fatigue. Based on the results of echocardiography, an aneurysm of the left atrium was suspected. A free-breathing real-time cine magnetic resonance imaging with electrocardiograph synchronization confirmed the diagnosis of left atrial appendage aneurysm. The patient underwent an aneurysmectomy via a median sternotomy with cardiopulmonary bypass. Intraoperative transesophageal echocardiography revealed relative mitral insufficiency that was corrected with an annuloplasty ring. Intraoperative coronary angiogram showed impaired blood flow in the left main coronary and circumflex artery and 60% stenosis. For this reason, bifurcation stenting was performed. The patient had an uneventful postoperative clinical course and was discharged from the hospital on the 10th day in a satisfactory condition.
CONCLUSION
Left atrial appendage aneurysm is a rare and dangerous heart pathology that requires surgery to prevent related complications.
Core Tip: Left atrial appendage aneurysm is one of the rare, but potentially hazardous heart defects. We present a case of left atrial appendage aneurysm resection and mitral valve annuloplasty. This case highlights the fact that the disease is diagnosed either by chance or when examining the patient as a result of complications. Echocardiography in most cases will make it possible to establish the diagnosis, but magnetic resonance imaging is necessary for a more detailed assessment of changes in the heart. Surgical treatment is indicated for all patients to prevent fatal disorders.
