Key result
Multimodality imaging successfully diagnosed lipomatous atrial septal hypertrophy with an atrial septal defect, guiding a successful ICE-guided percutaneous occlusion with good clinical response.
Why the study?
Lipomatous atrial septal hypertrophy with atrial septal defect is a rare congenital anomaly where multimodal imaging is crucial for accurate diagnosis, treatment, and follow-up.
Case Report (n=1)
Multimodality imaging is crucial for the accurate diagnosis and procedural guidance of percutaneous occlusion in patients with rare concurrent lipomatous atrial septal hypertrophy and atrial septal defect.
Multimodal imaging aids LASH-ASD diagnosis; leaves open arrhythmia risk and management questions.
Background: Lipomatous atrial septal hypertrophy (LASH) with atrial septal defect (ASD) is a rare congenital anomaly. Although LASH is a histologically benign cardiac lesion characterized by excessive fat deposition in the interatrial septum that spares the fossa ovale, it has been associated with supraventricular arrhythmias or sick sinus syndrome. Application of multimodal imaging is crucial for accurate diagnosis, appropriate treatment of LASH with ASD, and follow-up. Case summary: A 68-year-old female patient presented with recurrent chest tightness and palpitation. Multimodal imaging revealed the characterizations of LASH and ASD. Two-dimensional transesophageal echocardiography showed a "dumbbell"-shaped involvement of the cephalad and caudal regions with sparing of a single secundum ASD. The septum with a brightness feature is an uncommon condition characterized by the deposition of unencapsulated fat cells in the atrial septum. Real-time four-dimensional transesophageal echocardiography reflected the lipomatous hypertrophy of the atrial septum and an oval-shaped ASD. Cardiac computer tomography angiography later confirmed this finding. The patient achieved a good clinical response with an ASD percutaneous occlusion guided by intracardiac echocardiography (ICE). Conclusion: This case demonstrates a LASH combined with ASD. Multimodality imaging can provide an accurate diagnosis and may guide the procedure for precise occlusion.
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Yu et al. (2023) conducted a case report in Lipomatous atrial septal hypertrophy (LASH) with atrial septal defect (ASD) (n=1). Multimodality imaging and ICE-guided percutaneous occlusion was evaluated on Clinical response and diagnostic accuracy. Multimodality imaging successfully diagnosed lipomatous atrial septal hypertrophy with an atrial septal defect, guiding a successful ICE-guided percutaneous occlusion with good clinical response.
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