Endoscopic Resection of a Giant Left Atrial Appendage

A 23-year-old woman with a history of arterial hypertension presented to our institution complaining of dyspnea and chest pain. Her workup including echocardiography and magnetic resonance imaging revealed an aneurysm of the left atrial appendage. No thrombus was identified in the aneurysm or left atrial appendage, and the patient was in sinus rhythm. She was started on prophylactic anticoagulation, and surgical resection of the aneurysm was recommended as a definitive treatment of this lesion. The surgery was performed using a minimally invasive left-sided thoracoscopy approach. The entire left atrial appendage including the aneurysm was removed at its base using an articulating endoscopic stapler device. On postoperative echocardiography, no residual left atrial appendage tissue was evident. The patient could be taken off oral anticoagulation and left the hospital in good condition.