A 44-year-old man was found to have a left ventricular mass by transthoracic echocardiography. He had had multiple events of systemic embolization over the last few years. The heart was not dilated, and heart function was normal. Surgical excision was recommended to avoid further embolization. A transverse aortotomy was carried out under cardioplegic cardiac arrest with standard cardiopulmonary bypass. A transaortic video-assisted endoscopic procedure was performed. The mass was resected endoscopically without left ventriculotomy. Pathologically, the excised mass was an organized thrombus with a fibrous stalk connected to endocardium. We thus report a case of left ventricular thrombus with a normally functioning heart.

A 67-year-old man who had no history of coronary artery disease was found to have electrocardiographic abnormalities. Coronary angiography showed a proximal coronary artery aneurysm and total occlusion of the distal right coronary artery. He underwent coronary artery bypass grafting and repair of the right coronary artery aneurysm. The pathology of the resected aneurysm wall was compatible with a diagnosis of coronary pseudoaneurysm. Spontaneous coronary artery pseudoaneurysm is a rare condition that has the potential risk of rupture or ischemia. Surgical repair and adequate coronary revascularization are reasonable for a possible coronary artery pseudoaneurysm.

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