Atrial Lipomatous Hypertrophy: Lipomatous Atrial Hypertrophy With Significant Involvement of the Right Atrial Wall

1993 ◽  
Vol 6 (1) ◽  
pp. 30-34 ◽  
Author(s):  
Ira S. Cohen ◽  
Krishnakant Raiker
2005 ◽  
Vol 8 (2) ◽  
pp. 96 ◽  
Author(s):  
Osman Tansel Dar�in ◽  
Alper Sami Kunt ◽  
Mehmet Halit Andac

Background: Although various synthetic materials and pericardium have been used for atrial septal defect (ASD) closure, investigators are continuing to search for an ideal material for this procedure. We report and evaluate a case in which autologous right atrial wall tissue was used for ASD closure. Case: In this case, we closed a secundum ASD of a 22-year-old woman who also had right atrial enlargement due to the defect. After establishing standard bicaval cannulation and total cardiopulmonary bypass, we opened the right atrium with an oblique incision in a superior position to a standard incision. After examining the secundum ASD, we created a flap on the inferior rim of the atrial wall. A stay suture was stitched between the tip of the flap and the superior rim of the defect, and suturing was continued in a clockwise direction thereafter. Considering the size and shape of the defect, we incised the inferior attachment of the flap, and suturing was completed. Remnants of the flap on the inferior rim were resected, and the right atrium was closed in a similar fashion. Results: During an echocardiographic examination, neither a residual shunt nor perigraft thrombosis was seen on the interatrial septum. The patient was discharged with complete recovery. Conclusion: Autologous right atrial patch is an ideal material for ASD closure, especially in patients having a large right atrium. A complete coaptation was achieved because of the muscular nature of the right atrial tissue and its thickness, which is a closer match to the atrial septum than other materials.


Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Natasja de Groot ◽  
Lisette vd Does ◽  
Ameeta Yaksh ◽  
Paul Knops ◽  
Pieter Woestijne ◽  
...  

Introduction: Transition of paroxysmal to longstanding persistent atrial fibrillation (LsPAF) is associated with progressive longitudinal dissociation in conduction and a higher incidence of focal fibrillation waves. The aim of this study was to provide direct evidence that the substrate of LsPAF consists of an electrical double-layer of dissociated waves, and that focal fibrillation waves are caused by endo-epicardial breakthrough. Hypothesis: LsPAF in humans is caused by electrical dissociation of the endo- and epicardial layer. Methods: Intra-operative mapping of the endo- and epicardial right atrial wall was performed in 9 patients with induced (N=4), paroxysmal (N=1), persistent (N=2) or longstanding-persistent AF (N=2). A clamp of two rectangular electrode-arrays (128 electrodes; inter-electrode distance 2mm) was introduced through an incision in the right atrial appendage. Series of 10 seconds of AF were analyzed and the incidence of endo-epicardial dissociation (≥15ms) was determined for all 128 endo-epicardial recording sites. Results: In patients with LsPAF the averaged degree of endo-epicardial dissociation was highest (24.9% vs. 5.9%). Using strict criteria for breakthrough (presence of an opposite wave within 4mm and <15ms before the origin of the focal wave), the far majority (77%) of all focal fibrillation waves could be attributed to endo-epicardial excitation. Conclusions: During LsPAF considerable differences in activation of the right endo- and epicardial wall exist. Endo-epicardial fibrillation waves that are out of phase, may conduct transmurally and create breakthrough waves in the opposite layer. This may explain the high persistence of AF and the low succes rate of ablative therapies in patients with LsPAF.


2017 ◽  
Vol 56 (1) ◽  
pp. 9
Author(s):  
C. G. HATZIGIANNAKIS (Χ.Γ. ΧΑΤΖΗΓΙΑΝΝΑΚΗΣ) ◽  
M. E. MYLONAKIS (Μ. Ε. ΜΥΛΩΝΑΚΗΣ) ◽  
M. N. SARIDOMICHELAKIS (Μ.Ν. ΣΑΡΙΔΟΜΙΧΕΛΑΚΗΣ) ◽  
M. PATSIKAS (Μ. ΠΑΤΣΙΚΑΣ) ◽  
D. PSALLA (Δ. ΨΑΛΛΑ) ◽  
...  

A 7-year old female collie (case 1), a 3-year old male Caucasian-cross (case 2) and three male German shepherds with an age of 11 (case 3), 8.5 (case 4) and 10 (case 5) years, respectively, were admitted with a history of decreased appetite, depression, exercise intolerance, dyspnea and progressive abdominal enlargement, for the last 10 to 60 days. Poor body condition (5/5), muffled heart sounds (5/5), weak femoral pulse (5/5), ascites (5/5), inspiratory or inspiratory-expiratory dyspnea (5/5), pulsus paradoxus (2/5) and jugular vein distension (2/5) were the prominent clinical findings, while mature neutrophilic leukocytosis (3/5), lymphopenia (3/5), eosinopenia (3/5), hypoproteinemia (5/5) and increased urea nitrogen (3/5) were the most prevalent clinicopathologic abnormalities. Apart from a space-occupying lesion onto the right atrial wall of one dog (case 4), radiographic and ultrasound examination showed a globe-shaped cardiac silhouette (5/5), pericardial effusion (5/5), ascites (5/5) and pleural effusion (4/5). A large amount of non-clotting hemorrhagic effusion was drained during pericardiocentesis, resulting in rapid clinical recovery. Physical, chemical and cytological evaluation of the pericardial fluid was non-contributory in the differentiation between neoplastic and non-neoplastic causes of these effusions. Case 3 died 25 days post-pericardiocentesis; right atrium hemangiosarcoma and pulmonary metastases were documented on post mortem histopathological examination. Another dog (case 5) died of unknown causes one month after pericardiocentensis. On the contrary, dogs 1, 2 and 4 were still clinically healthy for a followup period of 16, 2 and 8 months, respectively.


2001 ◽  
Vol 8 (4) ◽  
pp. 283-285 ◽  
Author(s):  
Nam T Tran ◽  
Adam Zivin ◽  
Darius Mozaffarian ◽  
Riyad Karmy-Jones

Implantable cardioverter defibrillator (ICD) placements can be associated with serious complications. This paper reports a patient in whom percutaneous placement of an ICD resulted in a hemopneumothorax. This was due to an active fixation lead that perforated the right atrial wall and injured the adjacent lung parenchyma. The hemothorax was drained thoracoscopically, and the atrial injury was covered with fibrin glue.


1999 ◽  
Vol 24 (2) ◽  
pp. 136-137 ◽  
Author(s):  
HIROFUMI FUJII ◽  
SEIEI YASUDA ◽  
MICHIRU IDE ◽  
WAKOH TAKAHASHI ◽  
AKIRA SHOHTSU ◽  
...  

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Timm Dickfeld ◽  
Martin Engelhardt ◽  
Katrina Read ◽  
Christopher Kocher ◽  
Jagan Akella ◽  
...  

Background: Recent ablation strategies for complex arrhythmias such as atrial fibrillation or ischemic ventricular tachycardia are increasingly based on anatomic considerations. While fluoroscopy and 3D-mapping systems are widely used to guide these ablations, they are limited by poor soft tissue visualization and the lack of real-time anatomic data. Therefore, this study sought to evaluate if real-time computed tomography (RT-CT) could overcome these limitations and guide catheter navigation, transseptal puncture and anatomically targeted ablation. Methods: Catheter real-time guidance was assessed in 5 swine (40kg) using a 40-slice RT-CT. First, right/left heart catheterization was performed from the femoral vein and artery with the goal to access all cardiac chambers and the great cardiac vessels. Second, transseptal puncture was attempted with targeted ablations at pre-specified locations at the left lateral wall. Third, targeted ablation at the pulmonary vein (PV) orifice and repeat ablations at the right lateral wall were created to assess accuracy and precision, respectively. Fourth, creation of a straight ventricular four-point line was attempted. Necropsy was performed to assess possible complications and to compare the location of the ablation sites with the CT images. Results: Catheter navigation was performed safely from the femoral vein to the pulmonary artery and the femoral artery to the left ventricle. Misguided catheters to the renal vein, jugular vein, and carotid artery were correctly identified and removed. Transseptal puncture using a Brocken-brough needle was successfully performed and confirmed with anatomically targeted ablations at the left lateral atrial wall. Accuracy as assessed by PV ablations was in the range of 1–3mm. Repeat ablations in the right atrial wall revealed a precision of 2–3mm. Maximum deviation from a straight 4-point ventricular line was 2.8mm. No complications were seen at necropsy. Conclusions: Catheter navigation (in all four cardiac chambers) as well as transseptal puncture can be performed guided exclusively by RT-CT. Anatomically targeted ablations can be created with good accuracy and precision under real-time guidance. This suggests a possible role of RT-CT to guide ablation procedures.


Author(s):  
Michelle Lee ◽  
Martin Yates ◽  
Alina Mistirian ◽  
Michael Sheaff ◽  
David Lawrence

We report a case of cardiac hibernoma, which is a very rare type of benign lipomatous tumour. They are usually asymptomatic and therefore remain undetected or are found incidentally. When symptomatic, they vary and depend on location of heart involved. The patient had a hibernoma on right atrial wall invading the intra-atrial groove and extending over superior vena cava (SVC), causing significant symptoms of SVC obstruction and tamponade. The patient therefore underwent emergency operation, in which the tumour was resected and the right atrium was reconstructed with Bovine pericardial patch. He was discharged home well.


2002 ◽  
Vol 130 (5-6) ◽  
pp. 217-221 ◽  
Author(s):  
Branislava Ivanovic-Krstic ◽  
Dimitra Kalimanovska-Ostric ◽  
Bosiljka Vujisic-Tesic ◽  
Dragana Jovanovic ◽  
Predrag Petrovic ◽  
...  

Cardiac hydatid disease is rare. We report on an uncommon hydatid cyst localized in the right ventricular wall, right atrial wall tricuspid valve left atrium and pericard. A 33-year-old woman was treated for cough, fever and chest pain. Cardiac echocardiograpic examination revealed a round tumor (5.8 x 4 cm) in the right ventricular free wall and two smaller cysts behind that tumor. There were cysts in right atrial wall and tricuspidal valve as well. Serologic tests for hydatidosis were positive. Computed tomography finding was consistent with diagnosis of hydatid cyst in lungs and right hylar part. Surgical treatment was rejected due to great risk of cardiac perforation. Medical treatment with albendazole was unsuccessful and the patient died due to systemic hydatid involvement of the lungs, liver and central nervous system.


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