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J Thorac Cardiovasc Surg 2007;133:820-822
© 2007 The American Association for Thoracic Surgery

Brief Communication

Surgical management of giant left atrial diverticulum

Jonathan McGuinness, AFRCSI, Ali Kindawi, FRCSI, Shaf Tajri, MRCS, Kevin Walsh, FRCPI, Lars Nolke, FRCSI, Alfred E. Wood, FRCSI*

Department of Paediatric Cardiac Surgery and Cardiology, Our Lady’s Hospital for Sick Children, Dublin, Ireland.

Received for publication May 2, 2006; accepted for publication September 6, 2006.

* Address for reprints: Alfred E. Wood, FRCSI, Department of Paediatric Cardiac Surgery, Our Lady’s Hospital for Sick Children, Crumlin, Dublin, Ireland. (Email: jmcguinness2@rcsi.ie).

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

Clinical Summary

After the incidental finding of a hyperdynamic precordium during a respiratory tract infection and subsequent note of cardiomegaly on a chest x-ray film, an asymptomatic 11/2-year-old girl was referred for transthoracic echocardiography. This showed dextroposition of the heart secondary to a giant diverticulum of the left atrium (Figure 1, A). Owing to this compression and its risk of progression, combined with the risk of thromboembolism, surgical plication was considered.


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  		Figure 1. A, Apical 4-chamber view demonstrates the diverticulum extending to the left ventricular apex. LA, Left atrium; LV, left ventricle; RA, right atrium; RV, right ventricle. B, Left coronary angiogram (left anterior oblique view) showing bowing of the circumflex coronary artery as it passed over the thrombosed diverticulum (arrows) with a dynamic distal stenosis during systole. LAD, Left anterior descending coronary artery; Circumflex, circumflex coronary artery.

 
Through a left posterolateral thoracotomy, the diverticulum was noted to extend . . . [Full Text of this Article]






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