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(Circulation. 2006;114:e511-e512.)
© 2006 American Heart Association, Inc.

Images in Cardiovascular Medicine

Giant Compressive Aneurysm of the Left Auricle in a 1-Day-Old Neonate

Thomas Strecker, MD; Andreas Koch, MD; Ralf L. Schild, MD; Helmut Singer, MD; Michael Weyand, MD; Albrecht Reimann, MD

From Center of Cardiac Surgery (T.S., M.W., A.R.), Department of Paediatric Cardiology, University Hospital for Children and Adolescents (A.K., H.S.), and Department of Obstetrics and Gynecology (R.L.S.), Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany.

Correspondence to Dr. Thomas Strecker, Center of Cardiac Surgery, Friedrich-Alexander-University of Erlangen-Nuremberg, Krankenhausstr. 12, D-91054 Erlangen, Germany. E-mail thomas.strecker@herz.imed.uni-erlangen.de

An extract of the first 250 words of the full text is provided, because this article has no abstract.

A 1-day-old boy who had been born at 40 weeks’ gestation weighing 3570 g was referred to our hospital for surgical resection of a giant compressive aneurysm of the left auricle. Fetal echocardiography at 34 weeks’ gestation had shown a large cavern structure lateral to the left atrium and left ventricle (Figure 1). At birth, the newborn was asymptomatic, and clinical examination was otherwise unremarkable. Immediate postnatal transthoracic echocardiography revealed a 30x35-mm large thrombotic aneurysm of the left auricle communicating with the left atrium through an orifice (Figure 2 and online-only Data Supplement). Because of the progressive compression of the left ventricle and the occurrence of an intracardiac thrombus, an early surgical management was required.

View larger version (85K): [in this window] [in a new window]   Figure 1. Four-chamber fetal echocardiography at 34 weeks’ gestation revealed a giant cavern structure lateral to the left atrium (LA) and the left ventricle (LV). This structure compressed the LV. The size of the cavern structure was 33x16 mm.

View larger version (94K): [in this window] [in a new window]   Figure 2. Immediate postnatal transthoracic echocardiography confirmed the large structure lateral of the left atrium (LA) and the left ventricle (LV). This structure appeared to communicate with the LA through an orifice, indicating an aneurysm within nonflowing thrombotic fluid.

Cardiopulmonary bypass was performed via aorto-bicaval cannulation with moderate hypothermia. Intraoperatively, there was a huge aneurysmatic sac of the left auricle that compromised the left ventricle (Figure 3). The aneurysmal left auricle was completely resected (Figure 4). At the end of surgery, the young patient was . . . [Full Text of this Article]

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Circulation 2006 114: 1343. [Extract] [Full Text]