Intraoperative Transesophageal Echocardiographic Findings in Surgical Resection of a Giant Right Atrial Diverticulum That Severely Compressed the Right Ventricle

Totally Endoscopic Resection of Right Atrial Diverticulum: A Case Report

“…In patients with RA diverticulum, palpitations due to atrial arrhythmias (atrial fibrillation, flutter, Wolff-Parkinson-White syndrome) is the most common symptom. 1,7,8 Chest pain or discomfort was recorded in 5 of 32 patients. [9][10][11][12][13] Compression of the tricuspid annulus and RV was a finding in large diverticula that extends through the atrioventricular groove to the lateral wall of RV.…”

“…[9][10][11][12][13] Compression of the tricuspid annulus and RV was a finding in large diverticula that extends through the atrioventricular groove to the lateral wall of RV. 1,5,14 Most authors agree that surgery is indicated when the patients have symptoms or the right cardiac structures were compressed. 6,15 Our patient had chest pain, tricuspid annular, and RV compression so the indication for surgery was clear.…”

“…In this circumstance, the posterior wall of the diverticulum often adheres tightly to these cardiac structures making it almost impossible to dissect and to completely remove the diverticulum without right coronary artery or RV injury. 1,17 For this reason, Iwata et al decided to leave a part of the diverticulum above the atrioventricular groove. 1 In our patient, we also decided to leave a part of the diverticulum adhering to the cardiac structures as well.…”

“…1,17 For this reason, Iwata et al decided to leave a part of the diverticulum above the atrioventricular groove. 1 In our patient, we also decided to leave a part of the diverticulum adhering to the cardiac structures as well.…”

“…However, all reports used conventional approach of sternotomy. 1,2 In this report, we describe a case of massive RA diverticulum that was successfully resected by totally endoscopic surgery (TES), on the beating heart. The ethical commission of the hospital approved the study protocol.…”