Small symptomatic pericardial diverticula treated by video-assisted thoracic surgical resection

There have been few reports about symptomatic pericardial diverticula. We describe 2 patients of symptomatic pericardial diverticula whose symptoms were relieved after surgery. The first patient complained of severe left anterior chest pain for a period of 6 months, and a pericardial diverticulum 4 x 3 cm in size was detected on the right side of the ascending aorta opposite the symptomatic side. The second patient complained of right anterior chest pain for a few months, and a pericardial diverticulum 6 x 2 cm in size was detected on the right side of the heart. Although these cysts did not appear large enough to cause symptoms, the patients underwent thoracoscopic resection. The postoperative course in each patient was uneventful, and the symptoms were relieved. We recommend that a symptomatic anterior mediastinal cyst be completely resected even if it does not appear large enough to compress the neighboring organs.