Congenital aneurysm of the left atrial appendage can be diagnosed via imaging and requires surgical intervention even in asymptomatic patients to prevent systemic embolism.
May support surgical consideration in asymptomatic congenital left atrial appendage aneurysm; hypothesis-generating from Level 5 evidence and requires prospective validation.
A case of congenital aneurysm of the left atrial appendage is presented and previously reported cases are reviewed. The diagnosis can be strongly suspected with the combination of an unusually prominent left heart border in the chest X-ray and two-dimensional echocardiographic findings of a large echo-free space close to the left atrium. The site of communication must be defined accurately and cardiac catheterisation and angiocardiography should be performed. Once the diagnosis is confirmed, surgery is indicated even in the asymptomatic patient because of the risk of systemic embolism.
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Robinson et al. (1984) studied this question.
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