Right lateral transthoracic approach mimicking standard transesophageal echocardiographic views in a patient with giant left atrium

We describe the case of a patient with long-standing severe mitral peripros thetic regurgitation and a giant left atrium. The patient was referred for surgery. On the third postoperative day, after resuture of the dehiscence o f the valve sewing ring, the patient complained of dyspnea. Transthoracic u ltrasound examination was performed to eliminate pleural effusion The sever e right lateral displacement of an aneurysmatic left atrial cavity contacti ng with the thoracic wall allowed us to obtain excellent images of the post erior cardiac anatomy by a right lateral thoracic view. The new transthorac ic approach made it possible to safely assess the atrial side of the mitral prosthesis, eliminating mitral regurgitation after surgery without transes ophageal echocardiographic examination (J Am Soc Echocardiogr 1999;12:275-7 .).