Giant Right Atrial Mass Following Surgical Aortic Valve Replacement

Keywords
Aortic Valve/surgery; Pericardial Effusion; Heart Atria/abnormalities

A 75-year-old man underwent elective biological aortic valve replacement. Two weeks after surgery, transthoracic echocardiography (TTE) showed a small pericardial effusion. On the following day, the patient suffered from syncope. A repeated TTE revealed a "giant" echo-dense mass (90x80 mm) occupying the entire right atrium and severely limiting tricuspid valve inflow. Although the initial differential diagnosis included the development of an intracavitary process, the rapidly-growing mass with a characteristic echo‑lucent layer at its atrial aspect (consistent with the atrial wall and visceral pericardium) (arrows) led to the final diagnosis of a pericardial hematoma mimicking a huge atrial mass. Emergency surgical exploration confirmed the diagnosis.

Figure 1
Transthoracic echocardiography: giant eco-dense mass occupying the entire right atrium (Panel A) and severely limiting tricuspid valve inflow (Panel B). Atrial wall and visceral pericardium (arrows)

• Sources of Funding
  There were no external funding sources for this study.
• Study Association
  This study is not associated with any thesis or dissertation work.

Publication Dates

• Publication in this collection
  Aug 2015

History

• Received
  09 Mar 2015
• Reviewed
  13 Mar 2015
• Accepted
  24 Mar 2015