Key result
Surgical resection successfully resolves rare, asymptomatic left atrial appendage aneurysm in a toddler.
Why the study?
Congenital left atrial appendage aneurysm is very rare, with unknown congenital causes and limited histopathological characterization.
Case Report (n=1)
Histopathological analysis of an asymptomatic congenital left atrial appendage aneurysm in a 2-year-old revealed muscle layer thinning and myxoid changes, suggesting underlying tissue damage as a potential etiology.
Successful aneurysmectomy in this asymptomatic toddler leaves open optimal management of congenital LAA aneurysms; larger series needed to clarify indications and etiology.
Semans and Taussig rst described congenital le atrial appendage aneurysm (LAAA) in 1938. However, it is very rare and has seldom been reported. e congenital reasons for its development are unknown. Although it is asymptomatic during the infantile period, it is usually resected in order to prevent symptoms that are commonly associated with it, including supraventricular arrhythmia, compression of the coronary arteries, dyspnea, intracardiac thrombus, and pulmonary venous stenosis. Here we report on the surgical management of an asymptomatic 2-year-old girl with this anomaly. Transthoracic and transesophageal echocardiography did not reveal thrombosis in the le appendage, and contrast-enhanced computed tomography of the LAAA demonstrated no abnormal structures. A er median sternotomy, aneurysmectomy was performed under cardiopulmonary bypass without cross-clamping. e patient underwent successful surgical resection of the aneurysm. Pathological examination revealed the three levels of atrial structure epicardial, myocardial, and endocardial layers; thinning of the muscular layer; and mucous degeneration, classifying the LAAA into an intrapericardial aneurysm of the le atrial appendage. Tissue destruction and the inability to maintain tissue homeostasis may have contributed to the formation of the LAAA.
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Tanabe et al. (2015) conducted a case report in Asymptomatic left atrial appendage aneurysm (n=1). Aneurysmectomy was evaluated. Aneurysmectomy was successfully performed in a 2-year-old girl with an asymptomatic left atrial appendage aneurysm, with histopathology revealing thinning of the muscular layer and mucous degeneration.
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