Inverted left atrial appendage bonded to atrial septum

Area of Science:

• Cardiology
• Pediatric Surgery
• Cardiac Surgery

Background:

• Congenital heart defects, such as partial atrioventricular defects and atrial septal defects, are common in pediatric patients.
• Surgical interventions are often necessary to correct these defects.
• Complications following cardiac surgery can arise, necessitating careful postoperative monitoring.

Observation:

• A 2-year-old boy with a partial atrioventricular defect and atrial septal defect developed a left atrial mass post-surgery.
• Transesophageal echocardiography identified the mass attached to the atrial septum, without obstructing left ventricle inflow.
• Surgical exploration was performed due to uncertainty regarding the mass's nature.

Findings:

• Intraoperative examination revealed the mass to be an inverted left atrial appendage (LAA).
• The inverted LAA was found to be accidentally attached to the atrial septum suture line.
• This finding highlights a rare surgical complication.

Implications:

• Increased awareness of inverted LAA can aid in accurate intraoperative diagnosis.
• Early recognition prevents unnecessary diagnostic procedures and treatments.
• This understanding can improve surgical outcomes and patient management in pediatric cardiac surgery.