Related Experiment Video
Updated: Jun 20, 2026
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Inverted left atrial appendage mimicking potential left atrial thrombus in an infant following cardiac surgery: a
Muhammad Najih Liaqath Ali1, Tara Bharucha1, Markku Kaarne2
1Department of Paediatric Cardiology, University Hospital of Southampton NHS Trust, Tremona Road, Southampton, Hampshire SO16 6YD, UK.
Insights
Inverted left atrial appendage (iLAA) is a rare cardiac surgery complication. Early intraoperative identification and manual reduction can resolve iLAA without further cardiopulmonary bypass.
Area of Science:
- Cardiology
- Cardiac Surgery
- Echocardiography
Background:
- Inverted left atrial appendage (iLAA) is an infrequent complication after cardiac surgery.
- It occurs in both pediatric and adult patients.
- This review discusses its occurrence, clinical features, differential diagnoses, and management.
Background:
Inverted left atrial appendage (iLAA) is an infrequent complication following cardiac surgery, seen both in children and adults. Following a recent encounter, this review article is aimed to remind the reader about its occurrence, clinical manifestations, differential diagnoses, and management options.
Case Summary:
A 3-month-old baby underwent successful surgical repair of a large ventricular septal defect. Intraoperative epicardial echocardiogram at the end of the case demonstrated an unexpected left atrial mass, raising suspicion of a thrombus adjacent to the mitral valve. Urgent re-establishment of cardiopulmonary bypass and exploration of the left atrium did not reveal a thrombus, but this was subsequently identified as an iLAA. This completely resolved after manual external reduction of the appendage.
Discussion:
Published literature is confined to case reports only, with most cases observed post-operatively, but some occurring spontaneously. Awareness of this unusual manifestation is particularly important in the intraoperative period as it can usually be addressed without the need for further cardiopulmonary bypass.
