Congenital absence of the left pericardium with extreme intrathoracic displacement of the heart. Case report and review of the literature.

Large pericardial defects are exceptional and difficult to diagnose. A 62-year-old man underwent elective coronary surgery which was seriously complicated by the unexpected intrapleural position of the heart due to the absence of a large amount of pericardium on the left. It appeared retrospectively that the patient had presented typical signs of the malformation and these are described in detail.