Author + information
- Received December 14, 2010
- Accepted January 5, 2011
- Published online November 29, 2011.
A 47-year-old woman presented with paroxysmal atrial flutter. Echocardiogram and computed tomography with 3-dimensional reconstruction revealed a massive right atrium (RA) with a giant aneurysm of the right atrial appendage and patent foramen ovale (PFO) (A). AO = aorta; RV = right ventricle.
Surgery was performed with a minimally invasive, video-assisted thoracoscopy, cardiopulmonary bypass, and cardioplegic arrest. After peripheral cannulation, the thoracic cavity was entered through a 3-cm inframammary incision in the fourth intercostal space. The right atrium and appendage were grossly enlarged and thinned out with a transition margin to normal atrium circumferentially. The diseased atrium was excised (B), the PFO closed, and a right-sided cryo-maze for atrial flutter ablation was performed (Online Video 1). The patient recovered uneventfully and was discharged after 3 days.
Right atrial aneurysm is a rare anomaly. Indications for resection include atrial arrhythmias or thrombus formation. We present a safe, minimally invasive approach for surgical treatment.
- Received December 14, 2010.
- Accepted January 5, 2011.
- American College of Cardiology Foundation