Double left atrial appendage: A diagnostic dilemma

• Main Authors: Nilanjan Dutta (Author), Debasis Das (Author), Unmesh Chakraborty (Author), Shubhadeep Das (Author), Manish Kumar Sharma (Author), Shivani Gajpal (Author), Amitabha Chattopadhyay (Author), Sanjiban Ghosh (Author), Jayita Nandy Das (Author)
• Format: Book
• Published: Wolters Kluwer Medknow Publications, 2023-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

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.

Item Description

0974-2069
10.4103/apc.apc_136_23