Acquired Left Atrial Opacity

Maddali, Madan Mohan; Kandachar, Pranav Subbaraya; Nadarajan, Kamalakannan

doi:10.1053/j.jvca.2015.12.020

Cited by 3 publications

(2 citation statements)

References 3 publications

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“…Various pathophysiologic theories have been proposed including spontaneous inversion, negative suction through the intracardiac vents during de-airing manouevres, 6 , 7 external compression from lung hyperinflation, and iatrogenic inadvertent inclusion of the LAA while closing the superior end of VSDs. 8 …”

Section: Discussionmentioning

confidence: 99%

Inverted left atrial appendage mimicking potential left atrial thrombus in an infant following cardiac surgery: a case report

Liaqath Ali,

Bharucha,

Kaarne

et al. 2024

European Heart Journal - Case Reports

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Background Inverted left atrial appendage (iLAA) is an infrequent complication following cardiac surgery, seen both in children and adults. Following a recent encounter, this review article is aimed to remind the reader about its occurrence, clinical manifestations, differential diagnoses, and management options. Case summary A 3-month-old baby underwent successful surgical repair of a large ventricular septal defect. Intraoperative epicardial echocardiogram at the end of the case demonstrated an unexpected left atrial mass, raising suspicion of a thrombus adjacent to the mitral valve. Urgent re-establishment of cardiopulmonary bypass and exploration of the left atrium did not reveal a thrombus, but this was subsequently identified as an iLAA. This completely resolved after manual external reduction of the appendage. Discussion Published literature is confined to case reports only, with most cases observed post-operatively, but some occurring spontaneously. Awareness of this unusual manifestation is particularly important in the intraoperative period as it can usually be addressed without the need for further cardiopulmonary bypass.

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Section: Discussionmentioning

confidence: 99%

Inverted left atrial appendage mimicking potential left atrial thrombus in an infant following cardiac surgery: a case report

Liaqath Ali,

Bharucha,

Kaarne

et al. 2024

European Heart Journal - Case Reports

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“…The authors previously reported an invagination of left atrial appendage probably due to a left atrial vent that was inserted through a patent foramen ovale during the repair of a child with Tetralogy of Fallot. 1 With this in mind, as well as the finding that the newly encountered left atrial opacity had the same echo density as the surrounding cardiac tissues, a careful examination of the appendage with minimal disturbance to the hemodynamic parameters was done. This revealed an inversion of the left atrial appendage and it was immediately restored to its normal configuration.…”

Section: Diagnosis: Left Atrial Appendage Inversionmentioning

confidence: 99%

A left Atrial Mass After COVID-19 and Cardiac Surgery

Maddali

Munasinghe

2022

Journal of Cardiothoracic and Vascular Anesthesia

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When a new left atrial mass is encountered following open-heart surgery, it is important to be aware of the possibility of a left atrial invagination prior to resorting to drastic measures especially in the critical period after separation from cardiopulmonary bypass. Intraoperative transesophageal echocardiography is of immense value and the mass has to be evaluated in multiple views before arriving at a definitive diagnosis.

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