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J Thorac Cardiovasc Surg 2005;130:e3-e4
© 2005 The American Association for Thoracic Surgery

Brief Communication

Extensive atrial wall resection in a patient with symptomatic idiopathic right atrial enlargement

Dante Picarelli, MD a , * , Alejandro Dodera, MD a , Serrana Antunez, MD b , Guillermo Touyá, MD a , Diego Abdala, MD b

a Division of Cardiac Surgery, Congenital Cardiac Unit, American Cardiac Center, American Hospital, Montevideo, Uruguay.
b Intensive Care Unit, Congenital Cardiac Unit, American Cardiac Center, American Hospital, Montevideo, Uruguay.

Received for publication May 23, 2005; revisions received June 21, 2005; accepted for publication June 30, 2005.

* Address for reprints: Dante Picarelli, MD, Unidad de Cardiopatías Congénitas y Trasplante, Centro Cardiológico Americano, Sanatorio Americano—Isabelino Bosch 2469, Montevideo 11600, Uruguay. (Email: picarelli54@hotmail.com).

The first 20% of the full text of this article appears below.


Figure 1
Dr Picarelli


Idiopathic right atrial enlargement is an uncommon cardiac anomaly, almost always asymptomatic and of unknown etiology. 1,2 Go Although frequently considered a relatively benign disorder, 3,4 Go this lesion may be associated with atrial arrhythmias, severe tricuspid regurgitation, thrombus formation, and even sudden death. 1-4 Go We report the case of a 45-year-old man who underwent surgical correction of symptomatic idiopathic right atrial enlargement.

Clinical Summary

A 45-year old-man with idiopathic right atrial enlargement was seen with chest discomfort, moderate dyspnea, and atrial fibrillation. At admission, pericardial effusion was suspected because of a markedly enlarged cardiac silhouette on chest radiography (Figure 1, A). Echocardiography performed during the patient's evaluation revealed an extremely enlarged right atrium, severe tricuspid insufficiency from annular dilatation, and a large intra-atrial thrombus (10 cm). Both ventricles were displaced leftward, with normal systolic function. Ebstein anomaly was excluded because of normal tricuspid valve attachment. The diagnosis of idiopathic right . . . [Full Text of this Article]






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