Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Nov 11;24(1):633.
doi: 10.1186/s12872-024-04323-x.

Left atrial appendage aneurysm: a descriptive systematic review of 177 cases

Yunis Daralammouri  1   2 , Anas Odeh  3 , Saad Abuzahra  3 , Murad Azamtta  3   4 , Ramzi Shawahna  5   6
Affiliations

Left atrial appendage aneurysm: a descriptive systematic review of 177 cases

Yunis Daralammouri et al. BMC Cardiovasc Disord. .

Abstract

Introduction: The left atrial appendage (LAA) is a distinct structure with unique developmental and structural characteristics. The LAA is involved in the formation of intra-atrial thrombi, particularly in patients with conditions such as atrial fibrillation and mitral valve disease. Left atrial appendage aneurysms (LAAA) are rare abnormal dilations of the LAA that may cause hazardous complications. However, there are limited data on the demographic features, clinical characteristics, management modalities, and prognosis of LAAA patients. This study aimed to conduct a systematic review of the reported cases of LAAA to explore the baseline characteristics, presentation, preferred diagnostic modalities, and optimal management of LAAA.

Methods: A systematic review was conducted following the PRISMA guidelines. We performed a literature search using MEDLINE/PubMed and Google Scholar. Eligible articles published between January 1940 and November 2022 were included. The eligibility criteria included case reports and case series of LAAA in English language articles. The data extracted included information on the authors, publication year, patient characteristics, signs/symptoms, diagnostic procedures, treatments, and outcomes.

Results: We identified 177 patients with LAAA in our study. There was a slight female predominance (50.9%), and the mean age was 29.7 years. Palpitations were the most common symptom reported, followed by shortness of breath and thromboembolic events. Transthoracic and transesophageal echocardiograms were the most common modalities for investigating and diagnosing LAAA, and the mean size of the aneurysm was 7.8 (5.7-9.6) × 5.9 (5.0-6.2) cm. Surgical resection is the treatment of choice for most patients with excellent prognoses. Older age and the presence of arrhythmia were significantly associated with thrombus formation and embolic events.

Conclusion: Left atrial appendage aneurysm is a rare but potentially life-threatening heart pathology that can lead to arrhythmias and thromboembolic events. Surgical resection appears to be the primary treatment option in the current literature, and most patients show improvement or are asymptomatic after treatment. Additionally, alternative approaches, such as transcatheter closure of LAAA, ablation, and medical treatments, have been reported as viable alternatives to surgical intervention.

Keywords: Atrial fibrillation; Left atrial appendage aneurysm; Mitral valve disease.

PubMed Disclaimer

Conflict of interest statement

Declarations Ethics approval and consent to participate Not applicable. Consent for publication Not applicable. Competing interests The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Search flow diagram
Fig. 2
Fig. 2
Age distribution of patients with LAAA
See this image and copyright information in PMC

References

    1. Al-Saady NM, Obel OA, Camm AJ. Left atrial appendage: structure, function, and role in thromboembolism. Heart. 1999;82(5):547–54. - PMC - PubMed
    1. Blackshear JL, Odell JA. Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation. Ann Thorac Surg. 1996;61(2):755–9. - PubMed
    1. Wilber DJ. Neurohormonal Regulation and the left atrial appendage: still more to learn. J Am Coll Cardiol. 2018;71(2):145–7. - PubMed
    1. Odell JA, Blackshear JL, Davies E, Byrne WJ, Kollmorgen CF, Edwards WD, et al. Thoracoscopic obliteration of the left atrial appendage: potential for stroke reduction? Ann Thorac Surg. 1996;61(2):565–9. - PubMed
    1. Beigel R, Wunderlich NC, Ho SY, Arsanjani R, Siegel RJ. The left atrial appendage: anatomy, function, and noninvasive evaluation. JACC Cardiovasc Imaging. 2014;7(12):1251–65. - PubMed

Publication types

LinkOut - more resources