Supramitral membrane with left atrial appendage thrombus: A rare entity.

Area of Science:

• Pediatric cardiology
• Cardiac surgery
• Echocardiography

Background:

• Supramitral membrane (SMM) is a rare congenital anomaly.
• Severe mitral stenosis (MS) can result from SMM, impacting cardiac function.
• Left atrial appendage (LAA) thrombus formation is a known complication of various cardiac conditions.

Observation:

• A 4-year-old child presented with SMM causing severe MS.
• Intraoperative transesophageal echocardiography identified a large thrombus in the LAA.
• This finding was concurrent with the SMM requiring surgical excision.

Findings:

• The study highlights an extremely rare co-occurrence of SMM-induced MS and LAA thrombus in a pediatric patient.
• Echocardiography proved vital for intraoperative detection of the LAA thrombus.
• Surgical intervention was performed for SMM excision.

Implications:

• This case emphasizes the need for thorough cardiac evaluation, including assessment for LAA thrombus, in pediatric patients with SMM and MS.
• Early detection and management of this rare association can prevent potentially catastrophic embolic events.
• Highlights the importance of advanced imaging like transesophageal echocardiography in complex pediatric cardiac cases.