Department of Pediatrics, Mayo Clinic, Rochester, MN, USA.
Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
World J Pediatr Congenit Heart Surg. 2023 Jul;14(4):474-480. doi: 10.1177/21501351231162909. Epub 2023 Mar 27.
Left (LAAA) and right atrial appendage aneurysms (RAAA) are rare entities, and their natural history, management, and long-term outcomes are not well studied.
This retrospective review includes all patients from 2000 to 2021 with atrial appendage aneurysms at our institution identified using an electronic search tool. LAAA and RAAA were confirmed using multimodality imaging and intraoperative findings.
We identified 13 (87%) patients with LAAA and 2 (13%) with RAAA. At diagnosis, 11 (73%) were female, mean age was 51.4 ± 18.8 years, and ejection fraction 56.5 ± 13.1%. Three (20%) patients had congenital heart disease including 2 (13%) with atrioventricular septal defects and 1 (7%) with congenitally corrected transposition. LAAA/RAAA was diagnosed due to new-onset atrial fibrillation (AF) in 6 (40%) patients and embolic stroke in 2 (13%). Ten patients had preexisting AF diagnosed 2.9 ± 1.4 years earlier at a mean age of 50.2 ± 15.5 years. Thrombus within the aneurysm was identified in 2 (15%) LAAA patients. All patients were on anticoagulation and follow-up of the cohort from diagnosis was 7.1 ± 6.2 years. Eleven (73%) patients were surgically managed with 7 (64%) lesions excised, 1 (9%) stapled, and 3 (27%) ligated. Postoperative complications occurred in 2 (18%) patients with 1 (7%) developing tricuspid regurgitation and another with pericardial effusion and tamponade.
Atrial appendage aneurysm is a rare disease and nearly half of patients present with AF. Surgical treatment with concomitant AF ablation is a reasonable and safe management option.
左心房（LAAA）和右心房（RAAA）的心房附件瘤是罕见的疾病，其自然病史、管理和长期结果尚未得到充分研究。
本回顾性研究包括 2000 年至 2021 年期间在我院使用电子搜索工具发现的所有患有心房附件瘤的患者。通过多模态成像和术中发现确认 LAAA 和 RAAA。
我们共发现 13 例（87%）LAAA 和 2 例（13%）RAAA。诊断时，11 例（73%）为女性，平均年龄为 51.4±18.8 岁，射血分数为 56.5±13.1%。3 例（20%）患者患有先天性心脏病，包括 2 例（13%）房间隔缺损和 1 例（7%）矫正型大动脉转位。6 例（40%）患者因新发心房颤动（AF）和 2 例（13%）因脑栓塞而诊断为 LAAA/RAAA。10 例患者有既往 AF，诊断时间为 2.9±1.4 年前，平均年龄为 50.2±15.5 岁。2 例（15%）LAAA 患者的瘤体内发现血栓。所有患者均接受抗凝治疗，从诊断开始对该队列的随访时间为 7.1±6.2 年。11 例（73%）患者接受手术治疗，其中 7 例（64%）行病变切除术，1 例（9%）行缝合术，3 例（27%）行结扎术。2 例（18%）患者术后出现并发症，其中 1 例（7%）发生三尖瓣反流，另 1 例发生心包积液和心包填塞。
心房附件瘤是一种罕见的疾病，近一半的患者表现为 AF。同时进行房颤消融术的手术治疗是一种合理且安全的治疗选择。
