Inversion of the left atrial appendage: a complication of cardiac surgery

An inverted left atrial appendage which fails to revert spontaneously is a rare complication of cardiac surgery. We present a case of an inverted left atrial appendage discovered intraoperatively on transoesophageal echocardiography. This was readily identified and was easily corrected with digital manipulation. Intraoperative transoesophageal echocardiography plus an awareness of the possibility that a newly presenting left atrial mass post-bypass might be an inverted left atrial appendage, facilitates immediate correction. So doing removes any need for further investigation or further cardiac surgery and reduces the risk of a subsequent thromboembolic event if the diagnosis is not made until later.