Giant Right Atrial Mass Following Surgical Aortic Valve Replacement
Teresa Bastante, Fernando Alfonso
Abstract
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Taxonomy
TopicsCardiac Structural Anomalies and Repair · Pericarditis and Cardiac Tamponade · Cardiac tumors and thrombi
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.