{"title":"双左心房阑尾：诊断难题。","authors":"Nilanjan Dutta, Debasis Das, Unmesh Chakraborty, Shubhadeep Das, Manish Kumar Sharma, Shivani Gajpal, Amitabha Chattopadhyay, Sanjiban Ghosh, Jayita Nandy Das","doi":"10.4103/apc.apc_136_23","DOIUrl":null,"url":null,"abstract":"<p><p>We report a unique intraoperative finding of an additional double left atrial appendage (LAA) during an arterial switch operation with ventricular septal defect closure in a 4-month-old girl. Immediately after the procedure, a prolapsing mass within the left atrium (LA) on the transesophageal echocardiogram raised concerns of a possible thrombus. The LAA was clearly visible with a pressure monitoring line which was put intraoperatively. To investigate further, cardiopulmonary bypass was resumed, and the heart was arrested and explored. There was an appendage-like structure, separate from the one that had the pressure monitoring line, which was inverted inside. It was pulled out from outside clearly establishing a double LAA. This report illustrates an example of a diagnostic dilemma caused by a double atrial appendage which was invaginated into LA masquerading as a mass or thrombus.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":0.9000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11098290/pdf/","citationCount":"0","resultStr":"{\"title\":\"Double left atrial appendage: A diagnostic dilemma.\",\"authors\":\"Nilanjan Dutta, Debasis Das, Unmesh Chakraborty, Shubhadeep Das, Manish Kumar Sharma, Shivani Gajpal, Amitabha Chattopadhyay, Sanjiban Ghosh, Jayita Nandy Das\",\"doi\":\"10.4103/apc.apc_136_23\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>We report a unique intraoperative finding of an additional double left atrial appendage (LAA) during an arterial switch operation with ventricular septal defect closure in a 4-month-old girl. Immediately after the procedure, a prolapsing mass within the left atrium (LA) on the transesophageal echocardiogram raised concerns of a possible thrombus. The LAA was clearly visible with a pressure monitoring line which was put intraoperatively. To investigate further, cardiopulmonary bypass was resumed, and the heart was arrested and explored. There was an appendage-like structure, separate from the one that had the pressure monitoring line, which was inverted inside. It was pulled out from outside clearly establishing a double LAA. This report illustrates an example of a diagnostic dilemma caused by a double atrial appendage which was invaginated into LA masquerading as a mass or thrombus.</p>\",\"PeriodicalId\":8026,\"journal\":{\"name\":\"Annals of Pediatric Cardiology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2023-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11098290/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Pediatric Cardiology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/apc.apc_136_23\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/4/1 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Pediatric Cardiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/apc.apc_136_23","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/4/1 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
我们报告了在为一名 4 个月大的女孩进行动脉转流手术并关闭室间隔缺损时，术中发现双左心房阑尾（LAA）的独特情况。手术结束后，经食道超声心动图显示左心房（LA）内有一个脱垂的肿块，这引起了她对可能存在血栓的担忧。术中放置的压力监测线清晰可见 LAA。为了进一步检查，恢复了心肺旁路，对心脏进行了停跳和探查。有一个类似阑尾的结构，与压力监测管线分开，倒置在里面。从外部将其拉出后，可以清楚地看到双 LAA。本报告举例说明了双心房阑尾伪装成肿块或血栓侵入 LA 所造成的诊断困境。
Double left atrial appendage: A diagnostic dilemma.
We report a unique intraoperative finding of an additional double left atrial appendage (LAA) during an arterial switch operation with ventricular septal defect closure in a 4-month-old girl. Immediately after the procedure, a prolapsing mass within the left atrium (LA) on the transesophageal echocardiogram raised concerns of a possible thrombus. The LAA was clearly visible with a pressure monitoring line which was put intraoperatively. To investigate further, cardiopulmonary bypass was resumed, and the heart was arrested and explored. There was an appendage-like structure, separate from the one that had the pressure monitoring line, which was inverted inside. It was pulled out from outside clearly establishing a double LAA. This report illustrates an example of a diagnostic dilemma caused by a double atrial appendage which was invaginated into LA masquerading as a mass or thrombus.
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