Isa Hideki, Nakatsu Tomoki, Kimura Fumiaki
Department of Cardiovascular Surgery, Kushiro Kojinkai Memorial Hospital, Aikoku 191-212, Kushiro 085-0062, Hokkaido, Japan.
J Surg Case Rep. 2022 Nov 28;2022(11):rjac549. doi: 10.1093/jscr/rjac549. eCollection 2022 Nov.
A left atrial appendage aneurysm (LAAA) is a rare congenital or acquired anomaly that often causes fatal complications. Although many reports recommend surgical resection for treatment, there is no clear definition of LAAA. Therefore, the diagnosis and treatment are ambiguous. A 73-year-old woman with cardiogenic stroke was admitted to our hospital because of a suspected LAAA as the source of the embolus. She was incidentally diagnosed with LAAA seven years ago, which was managed with continuous anticoagulation therapy, although atrial fibrillation was not observed. The patient underwent aneurysm resection, and the postoperative course was uneventful.As LAAA symptoms are nonspecific, careful observation is required when LAAA is suspected. The risks associated with surgery are generally low and the surgical outcome is good; however, even with appropriate medical therapy, fatal complications can occur. Therefore, surgical resection of the LAAA should be considered even in asymptomatic patients, considering the low surgical risk.
左心耳动脉瘤（LAAA）是一种罕见的先天性或后天性异常，常导致致命并发症。尽管许多报告推荐手术切除进行治疗，但LAAA尚无明确的定义。因此，其诊断和治疗尚不明确。一名73岁的心源性卒中女性因疑似LAAA为栓子来源而入住我院。她七年前偶然被诊断为LAAA，尽管未观察到房颤，但一直接受持续抗凝治疗。患者接受了动脉瘤切除术，术后过程顺利。由于LAAA症状不具特异性，怀疑LAAA时需要仔细观察。手术相关风险一般较低，手术效果良好；然而，即使进行适当的药物治疗，也可能发生致命并发症。因此，考虑到手术风险较低，即使是无症状患者也应考虑手术切除LAAA。
