Off-pump resection of an epicardial cyst using a minimally invasive approach.

Abstract A 25-year-old man presented with palpitation and was subsequently diagnosed with a large epicardial cyst (6.8×3.8 cm) originating from the left ventricle. The cyst compressed the left atrium and ventricle, leading to left ventricular diastolic dysfunction. Contrast-enhanced chest computed tomography revealed that the circumflex artery passed on or through the cyst. We successfully resected the cyst without using cardiopulmonary bypass via a left mini-thoracotomy with thoracoscope assistance. Then, the diastolic dysfunction improved. We suggest that most epicardial cysts could be treated in this fashion if the cyst is located in the left half of the heart.