title: Left atrial appendage aneurysm: a systematic review of 82 cases.
abstract: BACKGROUND
  Aneurysm of the left atrial appendage is rare. We sought to systematically review the published literature on left atrial appendage aneurysm (LAAA) to address its demographic features, clinical characteristics, treatment, complications, and outcomes.
  
  
  METHODS
  A systematic electronic search of Medline, PubMed, and EMBASE for case reports, case series, and related articles of LAAA published from 1962 until July 2013 was carried out. Statistical analysis was done using SPSS version 20.0. Logistic Regression Analysis was used to identify the independent predictors of LAAA-related thrombus formation and embolism.
  
  
  RESULTS
  Eighty-two cases of LAAA were identified. There was a slight female preponderance and most of the patients presented in their third decades. Palpitation, dyspnea or both were most common clinical symptoms associated with LAAA. Echocardiography was the main diagnostic modality used and the mean size of aneurysm was 7.08 ± 3.03 × 5.75 ± 2.36 cm. Surgical resection of the aneurysm was performed in most patients with favorable results. Systemic embolism and atrial tachyarrhythmias were the two common complications associated with untreated LAAA. Presence of atrial fibrillation/flutter was the only significant predictor of thrombus formation/embolic events.
  
  
  CONCLUSIONS
  Aneurysm of left atrial appendage is rare and often an incidental diagnosis during echocardiography. It is important to recognize this entity since it is associated with cardiovascular morbidity and mortality by predisposing to atrial tachyarrhythmia and thromboembolism. Surgical resection is the standard of treatment in the current literature. Medical management is directed toward the treatment of thromboembolism and atrial tachyarrhythmia.
authors: Department of Internal Medicine, Reading Health System, West Reading, Pennsylvania.
authors: Madan Raj
authors: MR
authors: Aryal
authors: Fayaz A
authors: FA
authors: Hakim
authors: Sailu
authors: S
authors: Ghimire
authors: Sushil
authors: S
authors: Ghimire
authors: Smith
authors: S
authors: Giri
authors: Anil
authors: A
authors: Pandit
authors: Yashoda
authors: Y
authors: Bhandari
authors: Naresh
authors: N
authors: Bhandari
authors: Ranjan
authors: R
authors: Pathak
authors: Paras
authors: P
authors: Karmacharya
authors: Rajesh
authors: R
authors: Pradhan
mesh_terms: D000293:Adolescent; D000328:Adult; D020517:Atrial Appendage / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006348:Cardiac Surgical Procedures / Q000379:methods / Q000401:mortality; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005260:Female; D006322:Heart Aneurysm / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D016019:Survival Analysis; D055815:Young Adult
keywords: aneurysectomy; atrial tachyarrhythmia; echocardiogram; left atrial appendage aneurysm; thromboebolism