Pradhan, Rajesh

BackgroundAneurysm of the left atrial appendage is rare. We sought to systematically review the published literature on left atrial appendage aneurysm (LAAA) to address its demographic features, clinical characteristics, treatment, complications, and outcomes.MethodologyA systematic electronic search of Medline, PubMed, and EMBASE for case reports, case series, and related articles of LAAA published from 1962 until July 2013 was carried out. Statistical analysis was done using SPSS version 20.0. Logistic Regression Analysis was used to identify the independent predictors of LAAA‐related thrombus formation and embolism.ResultsEighty‐two cases of LAAA were identified. There was a slight female preponderance and most of the patients presented in their third decades. Palpitation, dyspnea or both were most common clinical symptoms associated with LAAA. Echocardiography was the main diagnostic modality used and the mean size of aneurysm was 7.08 ± 3.03 × 5.75 ± 2.36 cm. Surgical resection of the aneurysm was performed in most patients with favorable results. Systemic embolism and atrial tachyarrhythmias were the two common complications associated with untreated LAAA. Presence of atrial fibrillation/flutter was the only significant predictor of thrombus formation/embolic events.ConclusionAneurysm of left atrial appendage is rare and often an incidental diagnosis during echocardiography. It is important to recognize this entity since it is associated with cardiovascular morbidity and mortality by predisposing to atrial tachyarrhythmia and thromboembolism. Surgical resection is the standard of treatment in the current literature. Medical management is directed toward the treatment of thromboembolism and atrial tachyarrhythmia.

BackgroundRight atrial appendage aneurysm (RAAA) is rare with fewer than 20 cases reported in the literature. We sought to systematically review the published cases of RAAA in terms of demographics, clinical characteristics, treatment, complications, and outcome.MethodologyElectronic search for case reports, case series, and related articles published until July 2013 was carried out and clinical data were extracted and analyzed.ResultsSeventeen cases of RAAA were identified with equal sex distribution and commonly presenting in the third decades of life. Dyspnea and palpitation were the most common clinical presentations. Echocardiography was the most common diagnostic modality. The mean size of aneurysm was 8.83 ± 4.84 × 6.05 ± 2.99 cm. Most of the patients were treated medically with close follow‐up. The mean follow‐up period was 10 months. Atrial tachyarrhythmias and heart failure were the most common complications.ConclusionRight atrial appendage aneurysm although rare may be associated with significant morbidity. Surgical resection is indicated in symptomatic patients.