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Transesophageal Echocardiogram Diagnosis of Postoperative Left Atrial Pseudoaneurysm with Spontaneous Healing

A case of asymptomatic left atrial wall rupture with pseudoaneurysm formation following coronary artery-bypass grafting (CABG) is illustrated. The patient was a 69-year-old man, who underwent a CABG in June 1994. During a routine postoperative transthoracic echocardiogram, a left atrium-adjacent cavity filled with high velocity fluid was seen. A pseudoaneurysm formation was suspected. Diagnosis was supported by transesophageal echocardiography and confirmed by cardiac MRI examination. The patient was not reoperated on for repair because of lack of symptoms and normal hernodynamic conditions. Transesophageal echocardiography was repeated forty days and eight months after CABG and revealed spontaneous disappearance of the left atrial pseudoaneurysm. At present (March 1996) the patient is as well as can be expected after CAJ3G and enjoys a good quality of life.