Is there an Unnoticed Etiology of Right Atrial Aneurysm?

A 12-year-old male was referred for surgery with the diagnosis of right atrial aneurysm. Resection of the right atrial aneurysm was performed under total cardiopulmonary bypass. Besides a very thin muscular layer, histopathological evaluation of the aneurysm specimen revealed extensive eosinophilic infiltration at the epicardial side which, from place to place showed penetrations into the muscular layer. The screening tests performed for determination of the etiology of eosinophilia were indeterminate supporting the diagnosis of idiopathic right atrial aneurysm. In conclusion, although the reason for the eosinophilia could not be detected, it may have a part in the development of right atrial aneurysm that merits further investigation.

Hunting the Hidden: Surgical Treatment of Chronic Silent Thrombus in the Left Ventricle. A Case Report.

Background: Silent left ventricular thrombus is dangerous. The current standard anticoagulation therapy is not effective, and the outcomes are frustrated.Case presentation: A 33-year-old man with silent left ventricular thrombus, which was detected incidentally by transthoracic echocardiography. After admission, anticoagulation with low-molecular-weight heparin therapy was carried out. Unfortunately, acute left temporal embolism emerged 5 days later, then the patient was transferred to the neurology department for further treatment. One month later, the patient received coronary artery bypass grafting (CABG), ventricular aneurysm resection and left ventricular thrombectomy and was discharged uneventfully after surgery.Conclusions: For the patients with giant or hypermobile left ventricular thrombus or recurrent systemic emboli, surgical treatment should be a priority.

Anterior Inferior Cerebellar Aneurysm Treated by Aneurysm Resection and Intracranial Artery Anastomosis in situ: A Case Report and Literature Review

Background: Anterior inferior cerebellar artery (AICA) aneurysms are relatively rare in clinical practice, accounting for <1% of all intracranial arteries. After the diagnosis and location are confirmed by angiography, magnetic resonance, and other imaging examinations, interventional, or surgical treatment is often used, but some complex aneurysms require reconstructive surgery.Case Description: An 8-year-old male child was admitted to the hospital due to sudden disturbance of consciousness for 2 weeks. The head CT showed hematocele in the ventricular system with subarachnoid hemorrhage in the basilar cistern and annular cistern. On admission, he was conscious, answered correctly, had a soft neck, limb muscle strength was normal, and had no cranial nerves or nervous system abnormalities. A preoperative examination showed the right side of the anterior distal arteries class under the circular wide neck aneurysm, the distal anterior inferior cerebellar artery supplying a wide range of blood to the cerebellum, the ipsilateral posterior inferior cerebellar artery absent, and the aneurysm close to the VII, VIII nerves. The aneurysm was successfully treated by aneurysm resection and intracranial artery anastomosis in situ of a2 AICA-a2 AICA.Conclusions: AICA aneurysms are relatively rare; in this case, a complex wide-necked aneurysm was successfully treated by aneurysm resection and anastomosis in situ of a2 AICA-a2 AICA. This case can provide a reference for the surgical treatment of complex anterior cerebellar aneurysms.

“Mycotic” coronary artery aneurysm and purulent pericarditis: The riddle of the chicken and the egg

Infected coronary artery aneurysms present high mortality and surgical management is the treatment of choice in most cases. We present a case of a giant infected aneurysm of the mid right coronary artery complicated with purulent pericarditis in an 83-year-old male patient. It is unknown whether the aneurysm or purulent pericarditis preceded. The patient underwent urgent aneurysm resection and coronary artery distal bypass grafting. He died 24 hours after the operation. When purulent pericarditis and ICAA co-exist the riddle of the chicken and the egg becomes apparent.

Congenital left atrial appendage aneurysm with unexpected course of left anterior descending coronary artery

The left atrial appendage (LAA) aneurysm is a rare condition that can produce local compressive effects and complications including supraventricular tachyarrhythmias, thromboembolic events and myocardial ischaemia. We present a rare case of a neonate with a congenital LAA aneurysm which resulted in local compressive effects on the left ventricle, severe mitral regurgitation and malposition of the left anterior descending (LAD) coronary artery. Intraoperatively, the LAD was found to be within the aneurysmal wall exterior to the left ventricular epicardium and was inadvertently injured during LAA aneurysm resection. Retrospective review of the preoperative computed tomography and echocardiography scans demonstrated the LAD lying within the wall of the LAA aneurysm, although this had not been well appreciated at that time. This highlights the importance of thorough multimodal preoperative imaging and intraoperative assessment for recognition of this rare association between the LAA aneurysm and LAD malposition, and prevention of inadvertent LAD injury during aneurysm resection.

LAPAROSCOPIC CORRECTION OF TYPE II ENDOLEAK AFTER AORTIC ANEURYSM RESECTION

The article presents a clinical case of laparoscopic surgical treatment of type II endoleaks after aortic aneurysm resection on shutdown and aorto-iliac bifurcation prosthetics. This complication developed a year after the operation and was verified by CT-aortography. The growth of the aneurysmal sac up to 5,7 cm in diameter and signs of endoleak due to the right lumbar artery at the L 4 level were detected. After appropriate preparation, laparoscopic resection of the aneurysmal sac and stitching of the lumbar artery was performed. The postoperative period was uneventful. The patient was rehabilitated as soon as possible. Observation for 36 months, blood flow in the aneurysmal sac is not determined. Thus, laparoscopic techniques can be successfully used to correct complications after operations for abdominal aortic aneurysm.