先天性巨大左心耳动脉瘤：一例报告
Congenital giant left atrial appendage aneurysm: a case report.
作者信息
Chen Yan, Mou Yun, Jiang Li-Jun, Hu Shen-Jiang
机构信息
Echocardiography and Vascular Ultrasound Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Department of Thoracic Cardiovascular Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
出版信息
J Cardiothorac Surg. 2017 Mar 16;12(1):15. doi: 10.1186/s13019-017-0576-6.
BACKGROUND
Congenital left atrial appendage aneurysm (LAAA) is a rare cardiac anomaly with potentially serious complications, including life-threatening systemic thromboembolism, atrial tachyarrhythmia, and cardiac dysfunction. Currently, early surgical intervention is generally recommended to prevent these complications.
CASE PRESENTATION
We present a case of congenital giant LAAA in a female patient who successfully completed pregnancy and underwent caesarean section with no obvious complications. Surgical resection of the LAAA was performed 3 years later, at the onset of chest pain resulting from compression of adjacent cardiac structures by the LAAA.
CONCLUSION
Surgical resection is recommended for the majority of patients with LAAA because of potential LAAA-related severe outcomes. However, clinical monitoring may be an optional strategy for asymptomatic patients without intra-atrial thrombus or other complications. Precise evaluation with echocardiography and brain magnetic resonance imaging is valuable for the subsequent management of LAAA.
背景
先天性左心耳动脉瘤（LAAA）是一种罕见的心脏异常，具有潜在的严重并发症，包括危及生命的系统性血栓栓塞、房性快速心律失常和心脏功能障碍。目前，一般建议早期手术干预以预防这些并发症。
病例报告
我们报告一例先天性巨大LAAA女性患者，该患者成功完成妊娠并接受剖宫产，无明显并发症。3年后，因LAAA压迫相邻心脏结构导致胸痛发作，对LAAA进行了手术切除。
结论
由于LAAA可能导致严重后果，大多数LAAA患者建议进行手术切除。然而，对于无症状且无心房内血栓或其他并发症的患者，临床监测可能是一种可选策略。超声心动图和脑磁共振成像的精确评估对LAAA的后续管理具有重要价值。
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