A 26-year-old female practising Jehovah's witness presented with a history
of recurrent respiratory infections since childhood and more recently, recu
rrent cardiac dysrhythmias. A large bronchogenic cyst arising beneath the c
arina and compressing the bronchi was felt to be responsible. The cyst was
adherent to the roof of the left atrium. She initially underwent a partial
excision through the standard approach of left thoracotomy. Complete resect
ion via this route was hazardous with real danger of laceration of the atri
al wall. Repeat surgery was performed on cardiopulmonary bypass 3 years lat
er for recurrence of symptoms. Complete excision was achieved.