PMC7509363_01
(a) The chest X-ray scan shows left pneumothorax and abnormal air density along the right border of the cardiac shadow (arrow heads). (b) The chest computed tomography scan reveals left pneumothorax, pneumopericardium, and a partial defect of the left pericardium (arrow).
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Chest X-ray showed mild pneumothorax in the left lung and abnormal air around the cardiac shadow (Fig. 1a). Chest computed tomography (CT) revealed the left pneumothorax, a small bulla in the lung apex, the pneumopericardium, and a discontinuity of the left pericardium (Fig. 1b).
The intraoperative thoracoscopic image shows a partial defect of the left pericardium at the level of the upper hilum. PA: pulmonary artery; AA: atrial appendage.
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The left atrial appendage was directly observed (Fig. 2).