Inversion of the Left Atrial Appendage Misdiagnosed as a Thrombus following Cardiac Surgery: A case report.
10.4097/kjae.2005.49.6.864
- Author:
Yong Min CHOI
1
;
Seong Deok KIM
;
Chong Sung KIM
;
Hee Soo KIM
;
Hae Jin PARK
;
Tae Gyoon YOON
Author Information
1. Department of Anesthesiology, Seoul National University College of Medicine, Seoul, Korea. ytg001@intizen.com
- Publication Type:Case Report
- Keywords:
left atrial appendage;
thrombus;
transesophageal echocardiography
- MeSH:
Atrial Appendage*;
Diagnostic Errors;
Echocardiography, Transesophageal;
Heart Atria;
Heart Septal Defects, Ventricular;
Humans;
Infant;
Monitoring, Intraoperative;
Reoperation;
Thoracic Surgery*;
Thromboembolism;
Thrombosis*;
Unnecessary Procedures
- From:Korean Journal of Anesthesiology
2005;49(6):864-867
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Transesophageal echocardiography (TEE) is now a common part of intraoperative monitoring in cardiac surgery. Intraoperative TEE offers substantial utility in detection of residual problems requiring reoperation. This report describes a 23 month old patient who was operated on for ventricular septal defect (VSD). TEE following VSD closure revealed a large thrombus in the left atrium (LA). Because of concern about the risk of thromboembolism, the LA was about to be re-explored after TEE demonstration. However, examination by the surgeon as compared with TEE revealed the mass to be an inverted left atrial appendage (LAA) that was easily everted, resulting in the disappearance of this mass on TEE. Echocardiographically, the inverted LAA appears as a mass mimicking a thrombus, a vegetation of the left atrium. Lack of awareness of this entity can result in a misdiagnosis and unnecessary procedures.
