心房阑尾动脉瘤:自然史和结果。

IF 1.1 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Michael P Penfold, Ikram-Ul Haq, Heidi M Connolly, Joseph A Dearani, Hartzell V Schaff, William R Miranda, Samuel J Asirvatham, Ammar M Killu, Arman Arghami, Elizabeth H Stephens
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引用次数: 0

摘要

背景:左心房(LAAA)和右心房阑尾动脉瘤(RAAA左心房(LAAA)和右心房阑尾动脉瘤(RAAA)是罕见的实体肿瘤,对其自然史、管理和长期预后的研究并不多:本回顾性研究包括本院 2000 年至 2021 年期间通过电子搜索工具发现的所有心房阑尾动脉瘤患者。通过多模态成像和术中发现证实了 LAAA 和 RAAA:我们发现了 13 名(87%)LAAA 患者和 2 名(13%)RAAA 患者。确诊时,11 名(73%)患者为女性,平均年龄(51.4±18.8)岁,射血分数(56.5±13.1%)。3名患者(20%)患有先天性心脏病,其中2人(13%)患有房室间隔缺损,1人(7%)患有先天性矫正性转位。6例(40%)患者因新发心房颤动(AF)而被诊断为LAAA/RAAA,2例(13%)因栓塞性中风而被诊断为LAAA/RAAA。10名患者在2.9±1.4年前就已诊断出心房颤动,平均年龄为50.2±15.5岁。2例(15%)LAAA患者的动脉瘤内发现了血栓。所有患者均接受了抗凝治疗,从确诊开始的随访时间为(7.1±6.2)年。11名(73%)患者接受了手术治疗,其中7名(64%)切除了病灶,1名(9%)进行了缝合,3名(27%)进行了结扎。2例(18%)患者出现术后并发症,其中1例(7%)出现三尖瓣反流,另1例出现心包积液和心包填塞:结论:心房阑尾动脉瘤是一种罕见疾病,近半数患者伴有房颤。结论:心房阑尾动脉瘤是一种罕见疾病,近半数患者伴有房颤,手术治疗同时进行房颤消融是一种合理而安全的治疗方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Atrial Appendage Aneurysms: Natural History and Outcomes.

Background: Left (LAAA) and right atrial appendage aneurysms (RAAA) are rare entities, and their natural history, management, and long-term outcomes are not well studied.

Methods: 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.

Results: 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.

Conclusions: 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.

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CiteScore
1.80
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