Double left atrial appendage: A diagnostic dilemma.

IF 0.9 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Annals of Pediatric Cardiology Pub Date : 2023-09-01 Epub Date: 2024-04-01 DOI:10.4103/apc.apc_136_23
Nilanjan Dutta, Debasis Das, Unmesh Chakraborty, Shubhadeep Das, Manish Kumar Sharma, Shivani Gajpal, Amitabha Chattopadhyay, Sanjiban Ghosh, Jayita Nandy Das
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Abstract

We report a unique intraoperative finding of an additional double left atrial appendage (LAA) during an arterial switch operation with ventricular septal defect closure in a 4-month-old girl. Immediately after the procedure, a prolapsing mass within the left atrium (LA) on the transesophageal echocardiogram raised concerns of a possible thrombus. The LAA was clearly visible with a pressure monitoring line which was put intraoperatively. To investigate further, cardiopulmonary bypass was resumed, and the heart was arrested and explored. There was an appendage-like structure, separate from the one that had the pressure monitoring line, which was inverted inside. It was pulled out from outside clearly establishing a double LAA. This report illustrates an example of a diagnostic dilemma caused by a double atrial appendage which was invaginated into LA masquerading as a mass or thrombus.

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双左心房阑尾:诊断难题。
我们报告了在为一名 4 个月大的女孩进行动脉转流手术并关闭室间隔缺损时,术中发现双左心房阑尾(LAA)的独特情况。手术结束后,经食道超声心动图显示左心房(LA)内有一个脱垂的肿块,这引起了她对可能存在血栓的担忧。术中放置的压力监测线清晰可见 LAA。为了进一步检查,恢复了心肺旁路,对心脏进行了停跳和探查。有一个类似阑尾的结构,与压力监测管线分开,倒置在里面。从外部将其拉出后,可以清楚地看到双 LAA。本报告举例说明了双心房阑尾伪装成肿块或血栓侵入 LA 所造成的诊断困境。
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来源期刊
Annals of Pediatric Cardiology
Annals of Pediatric Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
1.40
自引率
14.30%
发文量
51
审稿时长
23 weeks
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