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Accessory left atrial appendage

Case contributed by Arkadi Tadevosyan
Diagnosis certain

Presentation

Post-surgical state due to ascending aortic aneurysm graft repair. Suddenly noticed septae in atrial septae by follow up ultrasound.

Patient Data

Age: 50 years
Gender: Male

4mm triangular-shaped outpouching from the superomedial wall of the left atrium,  which has a wide base and smooth margins consistent with a left atrial accessory appendage.

Aortic size is within its normal limits. Poststernotomy wires are noted.

Annotated image

 Left atrial accessory appendage shown in arrowheads.

Case Discussion

High-resolution cardiac CT represents a unique and non-invasive tool to assess subtle anatomic cardiac anatomy and morphology. According to studies accessory left atrial appendages and diverticula can be found in more than one-fifth of subjects undergoing cardiac CTA and are more common in men. 
Accessory left atrial appendages tend to be smaller than diverticula and are more commonly found on the left lateral atrial wall. 

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