The aneurysmal dilatation of the left atrial appendage in the absence of demonstrable left ventricular or mitral valvular disease is very rare. Two such cases of isolated left atrial appendage aneurysm underwent successful surgical treatment at our institute. Two male patients aged 29 and 48 presented with palpitation and dyspnea on exertion (NYHA class 2). Their clinical examination and electrocardiogram revealed atrial fibrillation. The diagnosis was established by chest X-ray together with transthoracic and transesophageal echocardiography and was confirmed by contrast-enhanced computed tomography. An aneurysmectomy was done through the median sternotomy under cardiopulmonary bypass in view of associated moderate mitral regurgitation in one case and a possible clot in the aneurysm cavity in the other. Atrial fibrillation reverted to sinus rhythm during the immediate postoperative period and the follow-up at three months and one year revealed that the patients were asymptomatic with normal sinus rhythm.

Keywords : Aneurysm; left atrial appendage; mitral apparatus; spiral computed tomography scan