Inverted left atrial appendage mimicking a left atrial mass after surgical repair of an atrial septal defect: a case report
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Inverted left atrial appendage mimicking a left atrial mass after surgical repair of an atrial septal defect : a case report. / Buttar, Sana N.; Andersen, Henrik Ø.; Poulsen, Jesper B.; Thyregod, Hans Gustav H.
In: European Heart Journal - Case Reports, Vol. 6, No. 7, ytac241, 2022.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Inverted left atrial appendage mimicking a left atrial mass after surgical repair of an atrial septal defect
T2 - a case report
AU - Buttar, Sana N.
AU - Andersen, Henrik Ø.
AU - Poulsen, Jesper B.
AU - Thyregod, Hans Gustav H.
N1 - Publisher Copyright: © 2022 The Author(s). Published by Oxford University Press on behalf of the European Society of Cardiology.
PY - 2022
Y1 - 2022
N2 - Background: Inverted left atrial appendage (ILAA) is a rare condition following cardiac surgery. Failure to recognize the condition or making misdiagnosis of a tumour, a thrombus or vegetation can lead to unnecessary and potentially adverse events. We present a case of ILAA after surgical repair of an atrial septal defect (ASD) in a young female. Case summary: A 3-year-old caucasian female was admitted for surgical repair of an ASD. The intraoperative course was uneventful until the opening of the right atrium (RA) after the commencement of cardiopulmonary bypass (CPB) and vacuum application, where the inferior vena cava (IVC) cannula was seen displaced in the RA. Cannula was repositioned, and ASD was repaired. On post-CPB transesohageal echocardiography (TEE), a newly developed mass was revealed in the left atrium (LA). The heart was re-arrested, and LA was re-assessed with unexpected finding of ILAA. ILAA was everted. RA was closed and CPB weaned off. Repeated post-CPB TEE showed no mass in the LA. No recurrence of mass was demonstrated on follow-up transthoracic echocardiography (TTE). Discussion: The incidence of ILAA is rare. Therefore, it is usually forgotten and not anticipated as a complication during heart surgery using CPB. In our case, dislodgement of the IVC cannula into the RA in combination with vacuum application in the setting of an ASD may have resulted in ILAA. This has not been reported in previous cases. ILAA should be suspected on intraoperative TEE if the mass is newly developed. Visual inspection of the left atrium appendage (LAA) in situ is recommended before chest closure.
AB - Background: Inverted left atrial appendage (ILAA) is a rare condition following cardiac surgery. Failure to recognize the condition or making misdiagnosis of a tumour, a thrombus or vegetation can lead to unnecessary and potentially adverse events. We present a case of ILAA after surgical repair of an atrial septal defect (ASD) in a young female. Case summary: A 3-year-old caucasian female was admitted for surgical repair of an ASD. The intraoperative course was uneventful until the opening of the right atrium (RA) after the commencement of cardiopulmonary bypass (CPB) and vacuum application, where the inferior vena cava (IVC) cannula was seen displaced in the RA. Cannula was repositioned, and ASD was repaired. On post-CPB transesohageal echocardiography (TEE), a newly developed mass was revealed in the left atrium (LA). The heart was re-arrested, and LA was re-assessed with unexpected finding of ILAA. ILAA was everted. RA was closed and CPB weaned off. Repeated post-CPB TEE showed no mass in the LA. No recurrence of mass was demonstrated on follow-up transthoracic echocardiography (TTE). Discussion: The incidence of ILAA is rare. Therefore, it is usually forgotten and not anticipated as a complication during heart surgery using CPB. In our case, dislodgement of the IVC cannula into the RA in combination with vacuum application in the setting of an ASD may have resulted in ILAA. This has not been reported in previous cases. ILAA should be suspected on intraoperative TEE if the mass is newly developed. Visual inspection of the left atrium appendage (LAA) in situ is recommended before chest closure.
KW - Cardiac surgery
KW - Cardiopulmonary bypass
KW - Case report
KW - Inverted LAA
U2 - 10.1093/ehjcr/ytac241
DO - 10.1093/ehjcr/ytac241
M3 - Journal article
C2 - 35911491
AN - SCOPUS:85134603373
VL - 6
JO - European Heart Journal - Case Reports
JF - European Heart Journal - Case Reports
SN - 2514-2119
IS - 7
M1 - ytac241
ER -
ID: 346060695