Surgical glue resembling left atrial thrombus

Area of Science:

• Cardiology
• Cardiac Surgery
• Medical Imaging

Background:

• Severe aortic regurgitation necessitates complex surgical intervention.
• Down syndrome presents unique challenges in cardiovascular surgery.
• Left atrial appendage inversion is a rare but significant surgical complication.

Purpose of the Study:

• To report a rare case of left atrial appendage inversion due to surgical glue.
• To highlight the diagnostic challenges posed by this complication.
• To discuss the implications for intraoperative and postoperative management.

Main Methods:

• Case report of a 41-year-old female with Down syndrome and severe aortic regurgitation.
• Description of homograft aortic root replacement procedure.
• Observation of left atrial appendage inversion following surgical glue application.

Main Results:

• Surgical glue application led to the inversion of the left atrial appendage.
• The inverted appendage mimicked a left atrial mass on imaging.
• This created a diagnostic dilemma during the surgical procedure.

Conclusions:

• Surgical glue can cause unexpected anatomical distortions.
• Careful intraoperative assessment is crucial to differentiate true pathology from iatrogenic changes.
• Awareness of such rare complications is important for cardiac surgeons.