Echocardiographic assessment of children with juxtaposition of the right atrial appendages :33 cases from a tertiary children’s medical center

  • Yu-qi Zhang, Department of Pediatric Cardiology, Shanghai Children’s Medical Center, Shanghai Jiaotong University, China
  • Dr Kun Sun, Department of Pediatric Cardiology, Shanghai Children’s Medical Center, China
  • Shu-wen Zhong, Department of Pediatric Cardiology, Shanghai Children’s Medical Center, Shanghai Jiaotong University, China
  • Guo-Zhen Chen, Department of Pediatric Cardiology, Shanghai Children’s Medical Center, Shanghai Jiaotong University, China

    • Objective: The objective of this study was to analyze echocardiographic characteristics of juxtaposition of the right atrial appendages (JRAA) and to evaluate the diagnostic value of color Doppler echocardiography.
    Methods: The echocardiographic characteristics of children with JRAA from 1998 to 2008 in our heart center were analyzed and compared with the findings of selective angiocardiography, magnetic resonance imaging (MRI) and surgical operation.
    Results: JRAA was diagnosed in 33 of 10880 patients by angiocardiography.Juxtaposed atrial appendages and abnormal spatial orientation of atrial septum were visualized by color doppler echocardiography in all patients from the parasternal short-axis scan at the level of the great arteries, parasternal long-axis view, apical four chamber view, and subcostal four chamber view. 28 cases were diagnosed correctly by echocardiography, in the remaining 5 cases, 3 cases were suspected with JRAA, but it could not be determined by echocardiography; 2 cases were missed. The most common associated anomalies were conotruncal malformations (16 cases with double outlet of right ventricle, 9 cases with pulmonary atresia, 5 cases with transposition of the great arteries, 1 case with tetralogy of Fallot) and tricuspid malformations( 6 cases with tricuspid straddle, 3 cases with tricuspid atresia, 2 cases with tricuspid valve stenosis). Surgical operation was performed in 21patients with 2 death.
    Conclusions: Based on the characteristic alteration of the plane of the atrial septum and visualization of the malpositioned right atrial appendages, JRAA could be accurately diagnosed by color doppler echocardiography.