Primary cardiac tumors are very rare in children. Rhabdomyoma is the most common benign tumor in fetuses and neonates. Most cases do not require any surgical intervention due to absence of clinical symptoms and a high rate of spontaneous regression within the first year of life. However, some neonates can have significant abnormalities of intracardial hemodynamics related to the obstruction of the left and right ventricle outflows; this is an indication to emergency surgery. As a rule, complete or partial resection of the tumor mass provides uneventful postoperative course and is not associated with a relapse of rhabdomyoma in the long-term.We present a clinical case of a 15-days old neonate who underwent an emergency surgery due to advanced tumor obstruction of the blood flow in the right ventricle outflow tract (RVOT). At preoperative echocardiography, there was a  pulmonary artery systolic pressure gradient of 90 mm Hg. Moderate hypoxemia (SaO2 90%), breathing rate of up to 55 per minute, together with echocardiographic results, indicated the impaired pulmonary blood flow and the need for the tumor resection. The tumor was completely resected through the right ventricle access with cardiopulmonary bypass and cardioplegia, with subsequent autologous pericardium patching of the right ventricle. The postoperative period was uneventful; the patient was extubated at day 2 and discharged at day 11 after surgery. The diagnosis of rhabdomyoma was confirmed histologically. At one month after surgery, no additional tumor masses were found in the heart chambers and septum.Rhabdomyoma causing severe obstruction of the RVOT in a  newborn is a  rare life-threatening complication of the natural course of benign heart tumors in children. The presence of dyspnea at rest, moderate desaturation, and echocardiographic data determined the rejection of the conservative management commonly adopted in most cases of cardiac rhabdomyomas, and were indications for an emergency surgery. In the long-term postoperative period, magnetic resonance imaging should be done to exclude tuberous sclerosis.

This article presents a clinical case of the successful surgical treatment of a newborn with intrapericardial teratoma, which was initially diagnosed in the postnatal period, complicated by multiple organ failure, including severe cardio-respiratory disorders and acute renal damage. The systematized results of clinical, electrophysiological, radiation, and morphological diagnostics during the initial examination and at the stages of supervision of the newborn are reported. On the nineteenth day of life, significant multidisciplinary cooperation was implemented to perform a radical surgical intervention to remove the intrapericardial teratoma in a patient in critical condition due to heart compression and intrathoracic tension syndrome, which determined the needed prosthetics for vital functions. Two months after the operation, the efficiency of the intervention and complex therapy was confirmed by the direct results and data of the infants examination. The organizational aspects provided newborns with emergency multidisciplinary specialized medical care.

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The Eustachian valve (EV) is located in the orifice of inferior vena cava and belongs to structures of the normal heart. It plays an important role in the fetal blood flow by directing the flow of blood from inferior vena cava through an open foramen ovale to the left atrium, thereby ensuring the systemic flow in a fetus and bypassing the pulmonary circulation. After birth and upon closure of the foramen ovale, the valve ceases to function and tends to regress. Usually, a prominent EV is a clinically non-significant ultrasound finding. In isolated cases, however, it can cause significant hemodynamic abnormalities and subsequent rhythm disorders, delayed fetal development and transient hypoxemia in newborns. It can extremely rare be a cause of blood right-toleft shunting through the foramen ovale leading to desaturation. Clinically it can manifest by central cyanosis in newborns and infants. The differential diagnosis is made in neonatal intensive care units. We present a  case of transient arterial hypoxemia in a  newborn with prominent EV and inter-atrial shunt. A  one-month old infant was transferred from the Department of Pediatric Cardiology with a  history of transient hypoxemic spells related to right-to-left shunting via atrial septal defect caused by obstruction of the tricuspid valve by the prominent EV. The instrumental findings including contrast-enhanced tomography supported this hypothesis. The patient was stable for subsequent 10 days of the follow-up, which allowed for further conservative managements until the conventional time point for children with an atrial septal defect. Potential regress of the prominent EV, as well as natural growth of an infant and his/hers intracardiac structures, provide mostly favorable outcome without a surgical intervention. This was clearly illustrated in the clinical case.