Year : 2016  |  Volume : 19  |  Issue : 4  |  Page : 722--723

Windsock deformity of interatrial septum


Keerthi Chigurupati1, Kirubanand Senniappan1, Shrinivas Gadhinglajkar1, Rupa Sreedhar1, Thomas Mathew2,  
1 Department of Anesthesia, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
2 Department of CVTS, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India

Correspondence Address:
Keerthi Chigurupati
Department of Anesthesia, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum - 695 011, Kerala
India

Abstract

Classical “Windsock deformity” is associated with ruptured aneurysmal sinus of Valsalva. The echocardiographic definition for Atrial septal aneurysm (ASA) in children based on dimensions is lacking. Rupture of an ASA, though uncommon, may lead to cardiac failure due to acute RV volume overload. An untreated ASA may be complicated with thrombus formation.



How to cite this article:
Chigurupati K, Senniappan K, Gadhinglajkar S, Sreedhar R, Mathew T. Windsock deformity of interatrial septum.Ann Card Anaesth 2016;19:722-723


How to cite this URL:
Chigurupati K, Senniappan K, Gadhinglajkar S, Sreedhar R, Mathew T. Windsock deformity of interatrial septum. Ann Card Anaesth [serial online] 2016 [cited 2020 Feb 28 ];19:722-723
Available from: http://www.annals.in/text.asp?2016/19/4/722/191565


Full Text



Classical “Windsock deformity” is associated with ruptured aneurysmal sinus of Valsalva. We describe an unusual presentation of an interatrial septal aneurysm as the “windsock deformity [Figure 1] and Video 1].”{Figure 1}

An 8-month-old girl with congenital heart disease who presented with acute exacerbation of breathing difficulty since 2 months was referred for intracardiac repair. Preoperative transthoracic echocardiography revealed a 3.7 mm ostium secundum atrial septal defect, 7.6 mm subarterial ventricular septal defect (VSD), and good left ventricular function. In the Operating room (OR), after a standard anesthesia induction, heart was examined using a micro-transesophageal echocardiography probe (IE 33; Philips Medical Systems) which revealed an aneurysmal interatrial septum that ruptured at the tip shunting left-to-right. It was freely floating inside the right atrium giving the appearance of a classic “Windsock deformity [Figure 1] and Video 1].” It was abutting against tricuspid valve but did not protrude inside the right ventricle (RV) [Figure 2]. During surgery, the redundant aneurysmal portion of the atrial septum was excised, and the defect was closed directly along with patch closure of the VSD.{Figure 2}

Atrial septal aneurysm (ASA) is defined as a localized “saccular” deformity generally at the level of fossa ovalis, protruding into the right or the left atrium [Figure 2]. The echocardiographic definition for ASA in children based on dimensions is lacking. An untreated ASA may be complicated with thrombus formation, systemic embolism, cardiac arrhythmias, infective endocarditis, and damage to tricuspid valve. Rupture of an ASA, though uncommon, may lead to cardiac failure due to acute RV volume overload. Excision of aneurysm followed by closure of the defect is the surgical treatment of choice.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.