Excerpt

An asymptomatic 4-month-old patient with uncomplicated tetralogy of Fallot was referred for surgical treatment. At surgery two intrapericardial brownish, solid masses were found within the pericardial cavity. One mass (15 × 10 × 10 mm) was loosely attached to the superior vena cava through a fibrotic attachment, whereas the other was more closely attached to the inferior vena cava (Fig. 1). During external inspection of the heart, an accessory muscle chamber believed to be a ventricular diverticulum (Fig. 2) was found on the inferior-basal aspect of the left ventricle with no relation to the coronary arteries. A 1 × 1-mm calcified path maintained communication between the ventricle and diverticulum. In addition to repair of tetralogy of Fallot, the two intrapericardial masses were excised and the diverticulum was removed, and the communication between the diverticulum and left ventricle was closed. The postoperative course was uncomplicated.

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