Right atrium

Author(s):  
Thierry Le Tourneau ◽  
Luis Caballero ◽  
Tsai Wei-Chuan

The right atrium (RA) is located on the upper right-hand side of the heart and has relatively thin walls. From an anatomical point of view, the RA comprises three basic parts, the appendage, the vestibule of the tricuspid valve, and the venous component (superior and inferior vena cava, and the coronary sinus) receiving the deoxygenated blood. The RA is a dynamic structure dedicated to receive blood and to assist right ventricular (RV) filling. The three components of atrial function are the reservoir function during ventricular systole, the conduit function which consists in passive blood transfer from veins to the RV in diastole, and the booster pump function in relation to atrial contraction in late diastole to complete ventricular filling. Right atrial function depends on cardiac rhythm (sinus or atrial fibrillation), pericardial integrity, RV load and function, and tricuspid function. Right atrial dimension assessment is limited in two-dimensional (2D) echocardiography. Right atrial planimetry in the apical four-chamber view is commonly used with an upper normal value of 18-20 cm2. Minor and major diameters can also be measured. Three-dimensional (3D) echocardiography could overcome the limitation of conventional echocardiography in assessing RA size. Right atrial function has been poorly explored by echocardiography both in physiological and pathological contexts. Although tricuspid inflow and tissue Doppler imaging of tricuspid annulus can be used in the exploration of RA function, 2D speckle tracking and 3D echocardiography appear promising tools to dissect RA function and to overcome the limitations of standard echocardiography.

2020 ◽  
Author(s):  
Eun-Young Choi ◽  
Eun Sun Kim ◽  
Jung-Yoon Kim ◽  
Su-Jin Park ◽  
Ja-kyoung Yoon ◽  
...  

Abstract BackgroundRecently, the patient’s age of atrial septal defect (ASD) treatment has been gradually decreasing. However, the most appropriate age and treatment method remain controversial. We hypothesized that treatment of ASDs in patients under 5 years would be able to adequately normalize bi-atrial function over one year after treatment. The purpose of this study is to confirm the normalization of hypothesized atrial function.MethodsData of fifteen patients who underwent surgical ASD closure under 5 years of age (Operation group), 15 patients who underwent percutaneous ASD closure (Device group), and 15 age- and gender-matched normal control patients (Control group) were extracted from our echocardiographic data. Conventional 2D images and 2D speckle tracking method were used to evaluate bi-atrial function.ResultsLeft atrial function, εS, εE, and εA showed no significant differences in the three groups. Indicators representing the right atrial function varied with the three groups. However, there were no significant differences in the global longitudinal strain of the right atrium between the Operation and Device groups.ConclusionsAfter ASD treatment, right atrial function recovery is less than that of the left atrium. The function of the right atrium is not normalized after more than one year of treatment for ASD in patients under 5 years. After ASD treatment, further follow-up of the bi-atrial function is necessary.


2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S Stojsic ◽  
A Ilic ◽  
S Tadic ◽  
D Grkovic ◽  
A Stojsic-Milosavljevic

Abstract Introduction Some authors have confirmed changes in function of the right hearth in different conditions with endothelial dissfunction, such as systemic hypertension and metabolic syndrome. During gestational hypertension (GH), endothelial disfunction is one of the main pathogenic causes of vasoconstriction and placental insuficiety and following intrauterine growth restriction. Few authors evaluated function of the right ventricle during gestational hypertension, but to our knoledge, there are no studies about right atrial function during gestational hypertension. Purpose We hypothesized that there are changes in right atrial function durig gestational hypertension, and wondered if they are reversible. Methods Study included 45 pregnant women. 25 with GH (defined as blood pressure ≥140/90mmHg that appeared after 20th week of gestation and disappeared within six weeks postpartum) and 20 normotensivewomen,as control. Function of right atrium and right ventricle was evaluated according to the last guidelines for chamber quantification. Additionally, right atrial function was assessed with p-p cycle speckle tracking. Echo was performed in the third trimester of pregnancy and 6 weeks after delivery. Results Parameters showed impairment of RV diastolic function. Women with gestational hypertension had E/e" over the normal value and higher than healthy pregnants, althow difference was not significant. ( 6.46 +- 4.7 vs 5.16 +- 1.9, p =0.66). TDI derived E" from lateral tricuspid annulus was significantly lower in hypertensive group (0.11 +- 0.03 vs 0.14 +- 0.03 p= 0.023). Atv – right ventricle late filling velocity was significantly higher in patients with GH (0.61 +- 0.1 vs 0.51+-0.12, p= 0.08) . All pregnant women had normal values of RA dimensions, RA endsystolic area, RA endsystolic volume (RAVs). RAVs was significantly larger in GH group (34.64 +-12 vs 27.9+- 9.89, p= 0.041) comparing to the controls, but when we indexed it to the BSA, difference disappeared. Peak longitudinal strain was signfificantly higher in hypertensive group (33.49+- 2.48 vs 28.05+- 4.52, p= 0.001). After Pearson correlation of peak longitudinal strain with parameters of right ventricle diastolic function was done, there was possitive correlation between peak longitudinal strain and Etv (right ventricle early filling velocity) in hypertensive group (r 0.646, p 0.017). Also RAVs positively correlated with LAVsI (r= 0.577, p= 0.019), and RAVsI positively correlated with LAVsI (r= 0.690, p = 0.019). After delivery all changes disappeared. Conclusion Our study indicates that right atrium accommodates to the hemodynamic and functional changes during gestational hypertension. It changes because of modified right ventricle diastolic function and probably in the same mode as left atrium. RA peak longitudinal strain is high, so function of the right atrium is preserved, and we assume that short time of mentioned changes during pregnancy, is the reason why.


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Christian Steinberg ◽  
Suzanne Boudreau ◽  
Felix Leveille ◽  
Marc Lamothe ◽  
Patrick Chagnon ◽  
...  

Hepatocellular carcinoma usually metastasizes to regional lymph nodes, lung, and bones but can rarely invade the inferior vena cava with intravascular extension to the right atrium. We present the case of a 75-year-old man who was admitted for generalized oedema and was found to have advanced HCC with invasion of the inferior vena cava and endovascular extension to the right atrium. In contrast to the great majority of hepatocellular carcinoma, which usually develops on the basis of liver cirrhosis due to identifiable risk factors, none of those factors were present in our patient.


2020 ◽  
Vol 2020 ◽  
pp. 1-14
Author(s):  
Qingbo Su ◽  
Xiquan Zhang ◽  
Hui Zhang ◽  
Yan Liu ◽  
Zhaoru Dong ◽  
...  

Purpose. This study aimed to retrospectively review the diagnosis and surgical treatment of uterine intravenous leiomyomatosis (IVL). Methods. The clinical data of 14 patients with uterine IVL admitted to our hospital between 2013 and 2018 were retrospectively analyzed, including their demographics, imaging results, surgical procedures, perioperative complications, and follow-up results. Results. The tumors were confined to the pelvic cavity in 7 patients, 1 into the inferior vena cava, 4 into the right atrium, and 2 into the pulmonary artery (including 1 into the superior vena cava). Only one case was misdiagnosed as right atrial myxoma before the operation, which was found during the surgery and was treated by staging surgery; all the other patients underwent one-stage surgical resection. Three patients underwent complete resection of the right atrial tumor through the abdominal incision, and one patient died of heart failure in the process of resection of heart tumor without abdominal surgery. During the 6–60 months of follow-up, 4 patients developed deep venous thrombosis of the lower extremity, and 1 patient developed ovarian vein thrombosis and pulmonary embolism. After anticoagulation treatment, the symptoms disappeared. One patient refused hysterectomy and the uterine fibroids recurred 4 years after the operation. Conclusion. Specific surgical plans for uterine IVL can be formulated according to cardiac ultrasound and computed tomography (CT). For the first type of tumor involving the right atrium, the right atrium tumor can be completely removed through the abdominal incision alone to avoid thoracotomy. The disease is at high risk of thrombosis and perioperative routine anticoagulation is required.


2018 ◽  
Vol 36 (2) ◽  
pp. 77-79
Author(s):  
Syed Al Nahian ◽  
Sonjoy Biswas ◽  
Rezaul Hassan ◽  
M Zahid Hasan

Renal cell carcinoma (RCC) is the commonest primary tumor of the kidney which may invade through the renal vein into the inferior vena cava (IVC), and then it can extend intraluminally with subsequent tumor-thrombus formation. Here we report a case involving excision of a primary RCC with tumor-thrombus involving IVC up to right atrium with the use of extracorporeal circulation. Single stage surgical procedure was performed in collaboration with a urological team aiming complete resection of primary tumor, para-aortic lymphadenectomy and removal of IVC thrombus extending to right atrium with the help of cardiopulmonary bypass. After arresting heart, RA was opened and the mass was removed through RA from IVC and hepatic vein level. Abdominal IVC was opened and the entire residual mass was removed from below also small amount of thrombus removed from left renal vein. Postoperative venous doppler showed no residual thrombus in venous system. Histopathology report confirmed papillary renal cell carcinoma. The patient was discharged from hospital in the 12th post-operative day without any complication.J Bangladesh Coll Phys Surg 2018; 36(2): 77-79


2010 ◽  
Vol 17 (7) ◽  
pp. 856-861 ◽  
Author(s):  
Murat Ozgun ◽  
Paulus Kirchhof ◽  
Alexander C. Bunck ◽  
Walter Heindel ◽  
Lars Eckardt ◽  
...  

2008 ◽  
Vol 24 (7) ◽  
pp. 703-710 ◽  
Author(s):  
Howard J. Willens ◽  
Debra P. Fertel ◽  
Jianxin Qin ◽  
Eugenio Labrador ◽  
Maureen H. Lowery

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