A left atrial aneurysm is a very rare cardiac anomaly that usually develops in the left atrial appendage. It usually develops congenitally, and has a risk of life-threatening complications. Here, we report a case of a growing aneurysm of the left atrium that was incidentally found in a 42-yr-old woman. Eighteen years prior, an abnormal cardiomegaly was found on a chest radiography for a pre-operative study. The chest radiography at this time demonstrated a more prominent cardiomegaly than the previous radiography findings. The left atrial aneurysm was diagnosed by echocardiography and cardiac catheterization. Although asymptomatic, she underwent a successful surgical excision to allay the possibilities of rupture, arrhythmia, heart failure, or thromboembolism. The surgical findings demonstrated an 8 x 15 cm sized saccular aneurysm at the left atrial appendage, and the pathologic findings showed three myocardial layers. The patient has been asymptomatic during the 15 months of follow-up. In conclusion, a congenital left atrial aneurysm can grow with time, even in asymptomatic cases, and an aneurysmectomy is a curative treatment, which can eliminate the potential complications.
Adult ; Echocardiography ; Female ; Heart Aneurysm/congenital* ; Heart Aneurysm/pathology* ; Heart Aneurysm/surgery ; Heart Aneurysm/ultrasonography ; Heart Atria/pathology* ; Heart Atria/surgery ; Heart Atria/ultrasonography ; Human

Adult ; Heart Aneurysm ; congenital ; Heart Atria ; pathology ; Humans ; Male

Adult ; Calcinosis ; Heart Aneurysm ; pathology ; Heart Ventricles ; Humans ; Male ; Thrombosis ; pathology

OBJECTIVETo analyze the clinic-pathologic features of elderly myocardial infarction patients (> 60 years) with and without left ventricular aneurysm formation.

METHODSBetween January 1980 and October 2009, 107 myocardial infarction patients were divided into aneurysm group (n = 31) and non-aneurysm group (n = 76) according to autopsy results and the clinic-pathologic features of the two groups were compared.

RESULTSPrevious angina pectoris history was significantly less in aneurysm group than in non-aneurysm group [45.2% (14/31) vs. 92.1% (70/76), P = 0.047]. Incidence of hypertension was significantly higher in aneurysm group than in non-aneurysm group [77.4% (24/31) vs. 36.8% (28/76), P = 0.033]. The percentage of single-vessel disease [54.8% (17/31) vs. 23.7% (18/76), P = 0.033] and the LAD disease [96.8% (30/31) vs. 51.3% (39/76), P = 0.048] were both significantly higher in aneurysm group than in non-aneurysm group. Heart failure and ventricular arrhythmias were more likely the cause of death in patients with aneurysm than patients without aneurysm [56.3% (18/31) vs. 19.7% (15/76), P = 0.007]. Aneurysm mostly located in left ventricular anterior wall and apex.

CONCLUSIONSOur results suggest that patients with left ventricular aneurysm formation are more likely to have hypertension, single-vessel disease and LAD disease, heart failure and ventricular arrhythmias but less previous angina pectoris than patients without left ventricular aneurysm formation. The common locations of ventricular aneurysm formation were left ventricular anterior wall and apex.

Aged ; Aged, 80 and over ; Female ; Heart Aneurysm ; complications ; pathology ; Heart Ventricles ; pathology ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; complications ; pathology

Cardiomyopathy, Hypertrophic ; complications ; pathology ; Electrocardiography ; Female ; Heart Aneurysm ; complications ; pathology ; Heart Ventricles ; pathology ; physiopathology ; Humans ; Middle Aged

OBJECTIVE: To analyze the morphological features and forensic pathological characteristics of cardiac ruptures of different causes for their differential diagnosis. METHODS: We analyzed the data of 44 autopsy cases of cardiac rupture from 2014 to 2017 in our institute, including 11 cases caused by blunt violence with intact pericardium, 4 caused by cardiopulmonary resuscitation (CPR), 9 by myocardial infarction, and 20 by aorta dissection rupture.The gross features and histopathological characteristics of cardiac rupture and pericardial effusion were analyzed and compared. RESULTS: Cardiac ruptures caused by blunt violence varied in both morphology and locations, and multiple ruptures could be found, often accompanied with rib or sternum fractures; the volume of pericardial effusion was variable in a wide range; microscopically, hemorrhage and contraction band necrosis could be observed in the cardiac tissue surrounding the rupture.Cardiac ruptures caused by CPR occurred typically near the apex of the right ventricular anterior wall, and the laceration was often parallel to the interventricular septum with frequent rib and sternum fractures; the volume of pericardial blood was small without blood clots; microscopic examination only revealed a few hemorrhages around the ruptured cardiac muscular fibers.Cardiac ruptures due to myocardial infarction caused massive pericardial blood with blood clots, and the blood volume was significantly greater than that found in cases of CPR-induced cardiac rupture ( < 0.05);lacerations were confined in the left ventricular anterior wall, and the microscopic findings included myocardial necrosis, inflammatory cell infiltration, and mural thrombus.Cardiac tamponade resulting from aorta dissection rupture was featured by massive pericardial blood with blood clots, and the blood volume was much greater than that in cases of cardiac ruptures caused by blunt violence, myocardial infarction and CPR ( < 0.05). CONCLUSIONS Hemorrhage, inflammatory cell infiltration, and lateral thrombi around the cardiac rupture, along with pericardial blood clots, are all evidences of antemortem injuries.
Aneurysm, Dissecting ; complications ; Aortic Aneurysm ; complications ; Cardiopulmonary Resuscitation ; adverse effects ; Forensic Pathology ; Heart Rupture ; etiology ; pathology ; Heart Rupture, Post-Infarction ; pathology ; Humans ; Myocardial Contusions ; complications

Adult ; Aneurysm, False ; diagnosis ; pathology ; Electrocardiography ; Female ; Heart Ventricles ; pathology ; Humans

Adolescent ; Aneurysm ; complications ; pathology ; Heart Neoplasms ; complications ; Heart Ventricles ; Hemangioma, Capillary ; complications ; Humans ; Male ; Pulmonary Artery ; Thrombosis ; complications ; pathology

Retrograde cerebral perfusion under hypothermic circulatory arrest is a simple and useful adjunct to avoid cerebral ischemic injury in the treatment of aortic arch pathology. In the surgery of distal aortic arch and proximal descending aortic lesions through the left thoracotomy incision, right atrium-retrograde cerebral perfusion (RA-RCP) through a venous cannula positioned into the right atrium is simpler than retrograde cerebral perfusion through superior vena cava. The time limits for RA-RCP during aortic arch reconstruction have yet to be clarified. We, herein, present a case with uneventful recovery after RA-RCP of 94 minutes during reconstruction of aortic arch and descending aorta. These data suggest that RA-RCP, as an adjunct to hypothermic circulatory arrest, may prolong the circulatory arrest time and thus prevent ischemic injury of the brain, even when RA-RCP exceeds 90 minutes.
Aneurysm, Dissecting ; Aorta, Thoracic* ; Brain ; Brain Ischemia ; Catheters ; Heart Atria ; Pathology ; Perfusion* ; Thoracotomy ; Vena Cava, Superior

Aged ; Coronary Angiography ; Endocardium ; pathology ; Heart Aneurysm ; diagnosis ; diagnostic imaging ; Humans ; Male ; Myocardial Infarction ; complications