CASE REPORT: A 54 year old female patient was seen in pulmonary medicine outpatient department with complaints of postnasal drip for 6 to 7 years and difficulty in breathing for past 2 years, progressive in nature and with moderate exertion and relieved by rest. No history of PND/ Orthopnoea. History of headache was present for 2 months and relieved with rest and painkillers. No history of palpitations and chest pain.Patient had history of asthma and was on tablet salbutamol and steroid nebulisation during periods of acute attack. Patient is not a known hypertensive, diabetic mellitus, seizures, bleeding diathesis, pulmonary tuberculosis, TIA or stroke. No similar complaints in family members. Patient is married and has 3 children alive and healthy. She had undergone hysterectomy 4 years back for dysfunctional uterine bleeding.Clinically patient was conscious, comfortable, oriented, a febrile. No pallor, cyanosis, Icterus or pedal edema. Saturation was 100% without O2.Heart rate was 84/min and BP was 110/70 mmHg. Cardiovascular examination was normal. Respiratory system revealed rhonchi and occasional basal crepts. Abdomen was normal and CNS system was normal without any neurological deficit.Investigations were done and blood investigations were within normal levels and eosinophil count was normal. Blood sugar, urea, creatinine and serum electrolytes were within normal levels. Xray chest was normal. ECG was normal with sinus rhythm and no ST-T segment changes. ECHOCARDIOGRAPHY:Left Atrial mass of size 3.5cm * 3.27 cm was present attached to floor of left atrium. No LA/LV dilatation. Normal cardiac valves. No pulmonary hypertension. LVEF was 64%.Angiogram done showed normal Epicardial coronaries. PROCEDURE:Under GA, midline sternotomy was done, pericardial patch harvested after opening pericardium. Systemic heparinisation given and standard aorta bicavalcanulation was done. Core cooled to 32 degrees centigrade and aorta was cross clamped. Plegic arrest of heart was done and RA opened and interatrial septum was opened. A mass of size 3*3 cm was seen attached to the floor of the LA and the same was excised without any spillage and sent for HPE.A thorough wash of LV cavity was done. Interatrial septum was closed using harvested pericardial patch using 4-0 prolene sutures. LA deairing was done. Core rewarmed to 33 degree centigrade and cross clamp removed. Heart picked up in normal sinus rhythm without defibrillation. RA was closed using 5-0 prolene. Heparin was neutralized with protamine. Adequate hemostasis was obtained. Decannulation done.Mediastinal drains were kept and wound closed in layers. Patient had stable hemodynamics and was shifted to CT-ICU ward. Patient was extubated after 4 hours of elective mechanical ventilation.