A Case of a Left Atrial Appendage Aneurysm in a Senior

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 75; no. 9; pp. 2429 - 2432
• Main Authors: SAKAO, Toshihiko, ISHIDA, Naoki, KAJIWARA, Shimsuke, OKADA, Kenzo, KIYOCHI, Hidenori, NAKAMURA, Tarou
• Format: Journal Article
• Language: Japanese; English
• Published: Japan Surgical Association 2014
• Subjects: left atrial appendage aneurysm
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.75.2429

A 68-year-old woman was referred to our hospital because of palpitation and short of breath from a neighboring hospital. Electrocardiogram revealed atrial fibrillation and a chest x-ray film showed projection of the third left aortic arch. Coronary CT angiography showed a huge left atrial appendage aneurysm. Transesophageal echocardiography revealed decreased blood flow into the left atrial appendage aneurysm. Intra-aneurysmal thrombus or embolism was considered possible, and on-pump cardiac arrest aneurysmectomy was performed. The removed aneurysm was 65 × 44 mm in diameter. The tissue at the communication opening between the left atrium and the aneurysm was so firm that it was closed by double continuous sutures by a 2-0 polypropylene thread. Her postoperative course was uneventful. Left atrial appendage aneurysm is believed to be congenital, but it is often detected in adults. On-pump cardiac arrest removal of the aneurysm is the common treatment. Recently a variety of methods have been reported as less invasive surgical procedures for atrial palpitation, and these procedures can also be applied to this disease.