Congenital absence of the left pericardium is a rare phenomenon occurring as a result of abnormal embryologic development of the left cardinal vein which normally develops into the left pleuropericardial membrane. Congenital pericardial defects can occur alone or in association with other congenital anomalies. Although diagnosis with conventional imaging techniques is difficult to make, this condition can be identified through chest X-ray by: (1) levo-rotation of the heart with displacement of the apex to the left, (2) linear shape of the left cardiac silhouette with erasure of the aortic knob, and (3) a flattened right cardiac silhouette in the absence of longstanding tricuspid valve regurgitation. Fig. 1 displays the above mentioned signs in an 18-year-old lady who underwent surgical closure of an ostium secondum atrial septal defect, in whom diagnosis of congenital partial absence of the left pericardium was suspected preoperatively.
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Accepted: April 9, 2008
Received: March 14, 2008
© 2008 Published by Elsevier Inc.