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Juxtaposition of atrial appendages. Reinterpretation as an accessory appendage or atrial diverticulum
Insights
Juxtaposition of atrial appendages, often seen with congenital heart defects, may represent an accessory appendage or atrial diverticulum. This finding aids in understanding complex cardiac malformations.
Area of Science:
- Cardiovascular Pathology
- Congenital Heart Disease
- Anatomical Variations
Background:
- Juxtaposition of atrial appendages is a rare congenital anomaly.
- Its association with other cardiac malformations requires further investigation.
Purpose of the Study:
- To investigate the pathological features of atrial appendage juxtaposition.
- To determine common associated cardiac anomalies.
- To re-evaluate the nature of this anomaly.
Main Methods:
- Retrospective autopsy study of 13 cases with atrial appendage juxtaposition.
- Detailed pathological examination of cardiac structures.
- Review of associated congenital heart defects.
Main Results:
- Juxtaposition of atrial appendages frequently co-occurs with transposition of great vessels, ventricular septal defect, patent foramen ovale, and tricuspid/pulmonic valve lesions.
- A common complex includes tricuspid atresia, septal communications, and transposition of great vessels.
- Cases exhibited accessory atrial appendages adjacent to the left atrial appendage.
Conclusions:
- Juxtaposition of atrial appendages is strongly associated with specific congenital heart malformation complexes.
- The anomaly should be considered an accessory appendage or atrial diverticulum rather than a distinct entity.
Abstract:
The pathological features of 13 cases with juxtaposition of the atrial appendages in the autopsy files of The Johns Hopkins Hospital were studied. The anomaly occurs most frequently in association with transposition of the great vessels, ventricular septal defect, patent foramen ovale, and obstructive lesions of the tricuspid and pulmonic valves. The malformation complex of tricuspid atresia, atrial and ventricular septal communication, and the transposition of the great vessels seems particularly common with juxtaposition of the atrial appendage. A recent case showed a small accessory right atrial appendage lying in juxtaposition to the left atrial appendage. In addition, a normally situated right atrial appendages in addition to well-formed accessory appendages lying in juxtaposition to the left atrial appendages. It seems that juxtaposition of the atrial appendages should be reinterpreted as an accessory appendage or atrial diverticulum.