The left atrial appendage (LAA) considerably varies in morphology and position. In rare cases, it can be juxtaposed on the right side. Here, we present the transesophageal echocardiography (TEE) images and surgical findings of two patients presenting for corrective surgery of their underlying congenital cardiac anomalies. While abnormal position of the LAA was detected in the first patient, juxtaposition of LAA was detected in second patient by TEE and confirmed intraoperatively.
Beigel R, Wunderlich NC, Ho SY, et al. The left atrial appendage: anatomy, function, and noninvasive evaluation. JACC Cardiovasc Imaging 2014;7(12):1251–1265. DOI: 10.1016/j.jcmg.2014.08.009.
Koplay M, Erol C, Paksoy Y, et al. An investigation of the anatomical variations of left atrial appendage by multidetector computed tomographic coronary angiography. Eur J Radiol 2012;81(7): 1575–1580. DOI: 10.1016/j.ejrad.2011.04.060.
Hahn RT, Abraham T, Adams MS, et al. Guidelines for performing a comprehensive transesophageal echocardiographic examination: recommendations from the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. Anesth Analg 2014;118(1):21–68. DOI: 10.1213/ANE.0000000000000016.
Naksuk N, Padmanabhan D, Yogeswaran V, et al. Left atrial appendage: embryology, anatomy, physiology, arrhythmia and therapeutic intervention. JACC Clin Electrophysiol 2016;2(4):403–412. DOI: 10.1016/j.jacep.2016.06.006.
Bansal M, Kasliwal RR. Echocardiography for left atrial appendage structure and function. Indian Heart J 2012;64(5):469–475. DOI: 10.1016/j.ihj.2012.07.020.
Charuzi Y, Spanos PK, Amplatz K, et al. Juxtaposition of the atrial appendages [internet]. Circulation 1973;47(3):620–627. DOI: 10.1161/01.cir.47.3.620.
Singhi AK, Pradhan P, Agarwal R, et al. Juxtaposed atrial appendages: a curiosity with some clinical relevance. Ann Pediatr Cardiol 2016;9(2):186–189. DOI: 10.4103/0974-2069.173546.
Van Praagh S, O'Sullivan J, Brili S, et al. Juxtaposition of the morphologically left atrial appendage in solitus and inversus atria: a study of 18 postmortem cases [internet]. Am Heart J 1996; 132(2 Pt 1):391–402. Available from http://dx.doi.org/10.1016/s0002-8703(96)90438-x.
Andersen ND, Pal JD, Lodge AJ. Atrial septal defect repair by inversion of a juxtaposed left atrial appendage. Cardiol Young 2012;22(1): 103–105. DOI: 10.1017/S1047951111000801.