Author + information
- Received May 26, 2009
- Accepted June 3, 2009
- Published online October 20, 2009.
A 27-year-old female patient with severe mitral regurgitation due to anterior leaflet prolapse underwent elective mitral repair. Polytetrafluoroethylene sutures were used to reconstruct the anterior leaflet chordae, and mitral annuloplasty was performed (A). While we were weaning the patient from cardiopulmonary bypass, we observed a 1.5- × 3-cm left atrial mass on transesophageal echocardiography (B, Online Video 1, C, Online Video 2). No intracardiac thrombus or other masses had been observed intraoperatively, although the left atrial appendage had protruded into the operative field (A, arrow). It was deduced from inspection of the left heart border that the echogenic structure was her inverted left atrial appendage. This inversion was corrected (D, Online Video 3) by filling the heart with blood, Valsalva maneuvers, and digital manipulation; the patient had an uneventful post-operative course. An inverted left atrial appendage occasionally mimics the appearance of intracardiac mass on echocardiography early and late after cardiac surgery.
- Received May 26, 2009.
- Accepted June 3, 2009.
- American College of Cardiology Foundation