FIGURE 1 Pre- and postoperative TTE images. (A) Pre-TTE parasternal long-axis view reveals dilated left coronary sinus (CS), (B) Color Doppler imaging with systolic aliased flow in the sinus node artery (SNA). (C) Apical four-chamber view shows a 7.1×7.4 cm giant aneurysm (white star) fistula into the right atrial appendage (RAA). (D-F) Post-TTE shows a hypoechogenic mass of collapsed aneurysm (white star) in the posterior of the left atrium (LA).