{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:21:26Z","timestamp":1787772086995,"version":"build-2784847793"},"reference-count":4,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats: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.<\/jats:p>","DOI":"10.4103\/apc.apc_136_23","type":"journal-article","created":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T02:00:41Z","timestamp":1712109641000},"page":"378-380","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Double left atrial appendage: A diagnostic dilemma"],"prefix":"10.4103","volume":"16","author":[{"given":"Nilanjan","family":"Dutta","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Narayana Superspeciality Hospital, Howrah, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debasis","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Narayana Superspeciality Hospital, Howrah, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Unmesh","family":"Chakraborty","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Narayana Superspeciality Hospital, Howrah, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shubhadeep","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiac Intensive Care, Narayana Superspeciality Hospital, Howrah, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manish Kumar","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Cardiac Anaesthesia, Narayana Superspeciality Hospital, Howrah, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivani","family":"Gajpal","sequence":"additional","affiliation":[{"name":"Department of Cardiac Anaesthesia, Narayana Superspeciality Hospital, Howrah, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amitabha","family":"Chattopadhyay","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Narayana Superspeciality Hospital, Howrah, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjiban","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Narayana Superspeciality Hospital, Howrah, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayita Nandy","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Narayana Superspeciality Hospital, Howrah, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,4,1]]},"reference":[{"key":"R1-20240901","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/S0025-6196(12)64946-5","article-title":"Age-related changes in normal human hearts during the first 10 decades of life. Part II (Maturity):A quantitative anatomic study of 765 specimens from subjects 20 to 99 years old","volume":"63","author":"Kitzman","year":"1988","journal-title":"Mayo Clin Proc"},{"key":"R2-20240901","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1136\/hrt.60.3.227","article-title":"The determination of atrial arrangement by examination of appendage morphology in 1842 heart specimens","volume":"60","author":"Sharma","year":"1988","journal-title":"Br Heart J"},{"key":"R3-20240901","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1093\/oxfordjournals.eurheartj.a060151","article-title":"Transoesophageal echocardiographic evaluation of atrial morphology in children with congenital heart disease","volume":"13","author":"Tuccillo","year":"1992","journal-title":"Eur Heart J"},{"key":"R4-20240901","doi-asserted-by":"crossref","first-page":"3112","DOI":"10.1161\/01.CIR.96.9.3112","article-title":"Anatomy of the normal left atrial appendage:A quantitative study of age-related changes in 500 autopsy hearts:Implications for echocardiographic examination","volume":"96","author":"Veinot","year":"1997","journal-title":"Circulation"}],"container-title":["Annals of Pediatric Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/apc.apc_136_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:28:45Z","timestamp":1787768925000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/apc.apc_136_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9]]},"references-count":4,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/apc.apc_136_23","relation":{},"ISSN":["0974-2069","0974-5149"],"issn-type":[{"value":"0974-2069","type":"print"},{"value":"0974-5149","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9]]},"assertion":[{"value":"2023-09-09","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-11","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}