UNASSIGNED: Anomalous pulmonary venous connection with malposition of septum primum (MSP) is a rare pediatric cardiovascular malformation. Although reports in the literature are scarce, accurate pre-operative imaging diagnosis is crucial for selecting the appropriate clinical intervention and determining the prognosis for affected children.
UNASSIGNED: In both case reports, the cardiovascular malformations were incidental findings. In the second case, an enlarged cardiac silhouette was observed on chest x-ray due to pneumonia, which was subsequently confirmed by ultrasound. Combined with computed tomography angiography examination, the diagnosis of MSP-type anomalous pulmonary venous connection was established.
UNASSIGNED: Comprehensive imaging examinations are essential in reducing misdiagnosis and achieving an accurate diagnosis of MSP-type anomalous pulmonary venous connection. The typical imaging findings for MSP-type anomalous pulmonary venous connection include absence or hypoplasia of the superior limbic band of the septum secundum, leftward displacement of the septum primum, and partial or total pulmonary vein drainage into the anatomical right atrium.

UNASSIGNED: Idiopathic cardiac osseous metaplasia in the right atrium of a 9-year-old boy, accompanied by right atrial Chiari network and right pulmonary artery embolism. This case is rare and can easily be misdiagnosed.
UNASSIGNED: We encountered a case of a 9-year-old boy with a 3.5 cm diameter neoplasm in the right atrium. Preoperative imaging diagnosis could not determine the nature of the tumor, and the initial clinical suspicion of cardiac myxoma. After admission, a cardiotomy to remove foreign bodies and a pulmonary artery thrombectomy were performed.
UNASSIGNED: Idiopathic cardiac osseous metaplasia is relatively rare, and it is even rarer to be accompanied by a Chiari network in the right atrium. Due to the location and characteristics of the lesion in this case, it is easy to be misdiagnosed as atrial myxoma in clinical practice. Whether it is idiopathic osseous metaplasia or myxoma, it needs to be performed surgical treatment and pathological examination can easily rule out the diagnosis of myxoma. However, as idiopathic cardiac metaplasia is difficult to encounter in clinical work and there are few reports in the literature, clinicians and pathologists need to consult more relevant literature. Learn to understand and master the disease through multi-party consultation.

BACKGROUND: Recent studies have shown that right atrial (RA) function are important predictors of cardiovascular morbidity and mortality. However, the study data about RA phasic function in obstructive sleep apnea syndrome (OSAS) patients are scarce, especially based on the left ventricular geometry. So, we aimed to assess the influence of left ventricular geometry on RA phasic function in OSAS patients via a multimodal echocardiographic approach.
METHODS: Total of 235 OSAS patients were enrolled in this cross-section study and underwent complete clinical, polysomnography, and echocardiography examinations. The OSAS patients were divided into four groups based on left ventricular mass index (LVMI) and relative wall thickness (RWT): normal geometry (NG), concentric remodeling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH). RA phasic function was evaluated via multimodal echocardiography approach (two-dimensional echocardiography biplane method [2DE]; two-dimensional speckle-tracking echocardiography [2D-STE]; and three-dimensional echocardiography [3DE]). The multiple linear regression analysis was used to determine the relationship between left ventricular geometry and RA phasic function.
RESULTS: The RA volume and indices increased from NG to CR to EH to CH. RA total emptying fraction and RA strain during systole decreased from NG to CR to EH to CH. RA passive emptying fraction and RA strain during early diastole similarly decreased. RA active emptying fraction and RA strain during late diastole also gradually increased similarly. In analyses that adjusted for gender, age, body mass index, systolic blood pressure, apnea-hypopnea index, LVMI, systolic pulmonary artery pressure, and right ventricular free wall thickness, CH was associated with RA reservoir and conduit function via 2DE area-length method, whereas CH and EH were associated with RA reservoir and conduit function via 2D-STE and 3DE method. Further, CH was associated with RA booster pump function via 2DE area-length method, 2D-STE, and 3DE method.
CONCLUSIONS: The RA volumes and phasic function varied with left ventricular geometry via multimodal echocardiography approach. CH had the apparent negative effect on RA phasic function.

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UNASSIGNED: The right atrial aneurysm is a rare cardiac malformation of unknown origin. It is typically asymptomatic but can occasionally lead to life-threatening and serious complications.
UNASSIGNED: We present a case of a right atrial aneurysm in an eight-year-old child who experienced complications including rupture of the atrial aneurysm, thrombosis, and recurrent large pericardial effusions over a one-month period. Following surgical treatment, the child had a favorable prognosis.
UNASSIGNED: A congenital right atrial aneurysm may manifest as either a widespread enlargement of the right atrium or a localized, smaller sac-like protrusion. In the latter case, diagnosis can be challenging to confirm through transthoracic echocardiography alone, and may require a cardiac computed tomography angiography examination for a definitive diagnosis. For patients experiencing recurrent large volumes of bloody pericardial effusion within one month, and exhibiting no atrial enlargement but showing abnormalities of the atrial wall in echocardiography, it is important to be vigilant about the potential for atrial aneurysm rupture in the heart. Timely treatment is essential to prevent the progression of the condition, which could otherwise result in a poor prognosis.

Right atrial (RA) structural and functional evaluations have recently emerged as powerful biomarkers for adverse events in various cardiovascular conditions. Quantitative analysis of the right atrium, usually performed with volume changes or speckle-tracking echocardiography (STE), has markedly changed our understanding of RA function and remodeling. Knowledge of reference echocardiographic values and measurement methods of RA volumes and myocardial function is a prerequisite to introduce RA quantitation in the clinical routine. This review describes the methodology, benefits and pitfalls of measuring RA size and function by echocardiography based on the current understanding of right atrial anatomy and physiological function and provides the current knowledge of right atrial function in related cardiac diseases.

A 46-year-old woman with stage 5 chronic kidney disease was unable to undergo hemodialysis treatment due to thoracic central venous obstruction (TCVO) and blockage of the tunneled cuffed catheter. This patient also presented with symptoms of TCVO. When percutaneous procedure was not possible, we resolved the obstruction with the innominate-to-right-atrial bypass grafting technique under extracorporeal circulation. There are few reports on this surgical approach. In terms of patient prognosis, this may be an effective solution to this problem.

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BACKGROUND: Persistent atrial fibrillation (PerAF) is often associated with right atrial (RA) enlargement. We investigated the efficacy of RA intervention in patients with PerAF and RA enlargement.
METHODS: Patients with PerAF and RA enlargement were randomised (1:1) to receive adjunctive RA ablation (left atrial [LA] + RA group; n = 60) or to receive LA ablation alone (LA-only group; n = 60). In the LA + RA group, RA ablation was performed if LA ablation failed to terminate AF. The primary end point was freedom from AF/atrial tachycardia (AT) recurrence at 12 months after a single ablation procedure without antiarrhythmic drug therapy.
RESULTS: In the LA + RA group, 40 patients (67%) required RA ablation. The LA + RA group had a higher rate of acute AF termination than the LA-only group (63.3% vs 36.7%; P = 0.003). At the end of 12-month follow-up, 42 patients (70%) in the LA + RA group were free of AF/AT recurrence, compared with 31 (51.7%) in the LA-only group (log rank P = 0.034; hazard ratio 0.549, 95% confidence interval 0.310-0.974). The rate of freedom from AF recurrence was also higher in the LA + RA group than in the LA-only group (81.7% vs 63.3%; log rank P = 0.019). The 2 groups had similar rates of adverse events (5% vs 3.3%; P = 0.648).
CONCLUSIONS: Adjunctive RA ablation increased the success rate of a single ablation in patients with PerAF and RA enlargement.
UNASSIGNED: ChiCTR220056844.