Right pulmonary vein and biatrial compression by a massive descending aorta aneurysm

Compression of superior vena cava, oesophagus and bronchus is well known, but atrial compression, especially left sided, in combination with right pulmonary vein compression is very rare. We report an unusual case in a Marfan patient of extrinsic biatrial and pulmonary vein compression caused by a descending thoracic aneurysm.