Figure Legends
Figure 1: A) Initial electrocardiogram showing supraventricular tachycardia at 218 bpm, B) Repeat electrocardiogram after administration of IV adenosine and metoprolol showing normal sinus rhythm with sinus arrhythmia.
Figure 2: Anteroposterior chest X-ray showing abnormal contour of the left heart.
Figure 3: Transthoracic echocardiography (TTE) findings. A) Short axis TTE view at level of mitral valve showing a large lateral echolucent structure, B) Apical 4 chamber TTE view showing large echolucent structure adjacent to left atrium (LA), C) Administration of Definity echo contrast confirming this to be an intra-cardiac structure communicating with the LA.
LA = left atrium, LV = left ventricle, RA = right atrium, RV = right ventricle, LAA = left atrial appendage.
Figure 4: Coronal (panels A and C) and axial (panel B) computerized tomography (CT) views showing the left atrial appendage aneurysm. LA = left atrium, LV = left ventricle, RA = right atrium, RV = right ventricle, LAAA = left atrial appendage aneurysm, Ao = Aortic valve, RUPV = right upper pulmonary vein, RLPV = right lower pulmonary vein, LUPV = left upper pulmonary vein.
Figure 5: Intraoperative images during left atrial appendage aneurysm (LAAA) resection. A) Initial appearance of the large LAAA (white arrow) seen on lateral aspect of the heart, B) LAAA (labeled) after full cardiopulmonary bypass (CPB) and decompression of the heart, C) Placement of a 50 mm AtriCure Clip (marked by asterisk*) at the base of the LAAA, D) Resection of the LAAA after placement of AtriCure Clip.
Video 1: Intraoperative video of left atrial appendage aneurysm (LAAA) resection.