Figure legends
FIGURE 1 Chest X-ray showed cardiomegaly with enlarged right atrial contour (A); The subxiphoid view of TTE showed the giant RAAA and the PFO (B); The apical four-chamber view showed large aneurysm, measuring 7.8 × 7.5 cm (C). a = aneurysm; LA: left atrium; LV: left ventricle; MV: mitral valve; PFO = patent foramen ovale; RA: right atrium; RAAA = right atrial appendage aneurysm; RV: right ventricle; TTE = transthoracic echocardiography; TV: tricuspid valve.
FIGURE 2 Enhanced cardiac computed tomography showed a large dilatation of the right atrium and atrial appendage. LA: left atrium; LV: left ventricle; RA: right atrium; RAAA = right atrial appendage aneurysm; RV: right ventricle.
FIGURE 3 The intraoperative TEE showed the thin wall of right atrial appendage aneurysm with a size of 6.1 × 7.9 cm (A); The 4-chamber view showed the right ventricle was compressed by the atrial appendage aneurysm (B). LA = left atrium; LV = left ventricle; MV = mitral valve; RA = right atrium; RAAA = right atrial appendage aneurysm; RV = right ventricle; TV = tricuspid valve.
FIGURE 4 The giant RAAA was found upon opening the pericardium (A); The resected sac of right atrial appendage aneurysm (B). RAAA = right atrial appendage aneurysm.
FIGURE 5 The postoperative TEE showed a normal cardiac structure and valve function (A); The postoperative TTE showed a decreased size of right atrium (B); Histopathological sections of the aneurysm showed thinned myocardium and proliferated blood vessels. (x100) (C). LA = left atrium; LV = left ventricle; MV = mitral valve; RA = right atrium; RV = right ventricle; TV = tricuspid valve.