Use of Transesophageal Echocardiography in making an accurat
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Abstract :
An inverted left atrial appendage after cardiac surgery is a rare finding and can be misinterpreted as a thrombus, mass, or vegetation. We report a case where intraoperative transesophageal echocardiography assisted in making an accurate diagnosis.

Introduction :
It is uncommon to discover a new left atrial mass postheart surgery. In addition to the usual differentials such as thrombus, vegetation, or tumors such as myxoma, we report a case of inverted left atrial appendage (LAA) that masqueraded as a left atrium (LA) mass.

Case Report :
A 39-year-old female patient with severe calcific aortic stenosis was planned for aortic valve replacement. Transesophageal echocardiography (TEE) done intraoperatively showed severe aortic stenosis with a peak gradient of 74 mmHg and moderate aortic regurgitation. During the surgery, a left ventricular vent was placed through a right superior pulmonary vein to prevent distension of the left ventricle due to the moderate aortic regurgitation [Figure 1]. After aortic valve replacement was done and the heart was beating adequately, the left ventricular vent was removed, following which a homogeneous hyperechogenic ovoid mass was seen in the LA on TEE [Figure 2] and [Figure 3].......

http://www.annals.in/article.asp?issn=0971-9784;year=2017;volume=20;issue=2;spage=248;epage=249;aulast=Kumaran
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