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Image of a left atrial mass after a cardiopulmonary bypass in a child
Khaled Hadeed1, Bertrand Leobon2, Yves Dulac1
1Pediatric Cardiology Unit, Children's Hospital, CHU Toulouse, Toulouse, France.
Insights
Left appendage inversion, a rare complication after heart surgery, can appear as a mass in the left atrium. This case highlights successful diagnosis and manual reversion, avoiding further surgery.
Area of Science:
- Cardiology
- Pediatric Cardiac Surgery
- Echocardiography
Background:
- Left appendage inversion is a rare cardiac complication, often occurring postoperatively after open-heart surgery.
- Accurate diagnosis is crucial to prevent unnecessary interventions and patient morbidity.
Observation:
- A 5-month-old infant presented with a large mass in the left atrium detected via transesophageal echocardiogram post-ventricular septal defect repair.
- The mass was identified as an inverted left atrial appendage.
Findings:
- Echocardiographic imaging confirmed left appendage inversion.
- Manual reversion of the appendage was successfully performed and documented.
Implications:
- Misdiagnosis of left appendage inversion can lead to unnecessary surgical procedures.
- Prompt and accurate echocardiographic diagnosis facilitates appropriate management and improves patient outcomes.
Abstract:
Invagination of an appendage into the left atrium is a rare complication. It occurs spontaneously or after open-heart surgery. In our case, a postoperative transesophageal echocardiogram, after closure of a ventricular septal defect in a 5-month-old infant, revealed a large mass in the left atrium. A diagnosis of a left appendage inversion was confirmed after external examination of the heart. Herein, we provide echocardiographic images before, during, and after manual reversion of the left appendage. Misdiagnosis of this complication could have led to an additional unnecessary surgical procedure that could have impacted on the patient's morbidity.
