Simultaneous surgery can be conducted with acceptable mortality. The occurrence of bleeding complications and incomplete lymph node dissection, however, indicates combined procedures only in patients requiring simultaneous surgery due to their disease or unable to tolerate a second operation.

We report a case of cardiac myxoma of the aortic valve. To our knowledge, this represents only the seventh such case ever documented. A 61-year-old woman underwent an echocardiography to screen for hypertensive-diabetic cardiac complications, which showed a mass on her aortic valve. Although she had not experienced a fever, the mass closely resembled a vegetation, resulting in an initial diagnosis of infective endocarditis. We extirpated the mass and repaired the aortic valve with the patient under cardiopulmonary bypass. The postoperative course was uneventful. Histological examination confirmed that the mass was a myxoma.

Background Right atrial myxoma is a rare anomaly. When present, it can rarely cause blood flow obstruction in the right cardiac chamber depending on its size and location. We herein report a rare case of a giant right atrial myxoma, which caused right heart failure due to tricuspid valve obstruction, along with our treatment experience. Case presentation A 59-year-old woman was admitted to our hospital for palpitations and edema of the lower extremity. Computed tomography image and transthoracic echocardiography showed a 57 mm × 63 mm giant tumor obstructing the tricuspid valve inflow. The tumor was excised surgically and the residual septal defect was repaired with a Dacron patch. Tricuspid valve annuloplasty was performed additionally. The postoperative course was uneventful and the patient was discharged on postoperative day 5. Conclusion Giant right atrial myxoma is a rare cause of tricuspid valve stenosis and right heart failure. Surgical resection is the most appropriate treatment option and should be performed as soon as possible after diagnosis.

Because of its rigidity and non-steerability, the presence of a horizontal aortic root poses a major anatomical issue during transcatheter aortic valve replacement (TAVR) with Evolut self-expanding valve. Previous studies have elucidated the difficulties of coaxial implantation of the self-expanding valve in patients with horizontal aorta, often resulting in increased complications and a lower device success rate. To date, most patients with extremely horizontal aorta (aortic root angle !70°) have been excluded from major TAVR clinical trials. Therefore, available data on TAVR with Evolut in this challenging anatomy are limited, and standardized treatment strategies and clinical results remain unknown. Herein, we report a clinical case series of TAVR with Evolut in extremely horizontal aorta. Among seven patients (aged 80-92 years; STS score, 12.6% ± 7.9%) who underwent TAVR with Evolut system, aortic root angle ranged from 71°to 83°(mean, 75.1°± 4.5°). All patients achieved device success with dedicated strategies and were clinically stable at 3-month follow-up. None of the patients had more than mild paravalvular leakage (PVL) at any point during follow-up.Complications in three patients included complete atrioventricular block requiring a permanent pacemaker implantation, cerebral infarction because of atrial fibrillation 3 days after TAVR, and cardiac tamponade requiring pericardiocentesis. In this case series, Evolut self-expanding TAVR in extremely horizontal aorta was effective and feasible with a high device success rate. Based on anatomical features, some dedicated strategies majorly contribute to the success of this procedure. Large-scale multicenter studies are required to confirm our findings.

We describe the case of a 71-year-old woman presenting with abdominal angina with an intra-aortic mass at the thoracoabdominal aorta that restricted blood supply to the organs. Initially, the intra-aortic mass was suspected to be a mural thrombus; thus, endarterectomy was performed. However, postoperative histopathological examination revealed an intimal sarcoma, which relapsed locally within a few months. Additional en bloc resection of the aorta with graft interposition was performed. Despite surgical therapy, splenic metastasis was detected a few months after the second surgery; therefore, palliative care was selected for the patient.