Myxoma of the aortic valve is an exceedingly uncommon condition. In this article, we report the case of a 72-year-old man with myxoma arising from the aortic valve. 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.

Primary spindle cell sarcoma in the heart is a very uncommon disease. Although primary atrial or pulmonary vein spindle cell sarcomas have been sporadically reported, pericardial spindle cell sarcoma is rarely seen in currently available data. The commentary here is on a primary pericardial spindle cell sarcoma that was preliminarily misjudged to be left main coronary artery disease.

Primary aortic sarcoma is a rare condition that is frequently associated with distal embolization. In addition, growth characteristics of primary aortic sarcoma lead to the narrowing of the involved aortic lumen. A 72-year-old Korean male with primary aortic sarcoma showed progressive unexplained blood pressure elevation that didn’t improve with additional antihypertensive drug therapy. Because follow-up measures were not taken, the patient ultimately developed hypertensive encephalopathy with concurrent embolic dissemination. Although we successfully performed open transcatheter embolectomy in both legs, the patient died because of multiple organ failure 3 days after surgery. Given the ominous prognosis for this condition, this case report highlights the fact that the value of early detection and prompt evaluation of altered vital signs should not be overemphasized. We describe a rare case of primary aortic sarcoma that showed hypertensive encephalopathy caused by thoracic aortic occlusion and also had embolic metastases to the lower extremities.

A coronary artery aneurysm is an uncommon disorder and is seen as a characteristic dilatation of a localized portion of the coronary artery. Clinical manifestation of a coronary artery aneurysm varies from an asymptomatic presentation to sudden death of a patient. Although coronary aneurysms are typically diagnosed by the use of coronary angiography, a new generation of coronary 64-slice multidetector computed tomography (64-MDCT) scanners have successfully been used for evaluating this abnormality in a noninvasive manner. In the present case, we performed coronary 64-MDCT scanning preoperatively and postoperatively on a patient with multiple giant coronary aneurysms. The use of coronary 64-MDCT may provide an evaluation technique not only for diagnosis but also for follow-up after surgery for this condition.

Background: To analyze early technical success and late clinical success after endovascular entry sealing for chronic type B dissection with special emphasis on the development of pseudoaneurysm, reintervention, false lumen and aortic remodeling. Methods: Retrospective analysis of a prospective database. We observed 151 patients (mean age 62,2 Ϯ 12,6 years, 67% male) in the period July 1999 to May 2010 with acute or chronic type B dissection treated by endovascular entry sealing. Serial contrastenhanced computed tomography (CT) scans of 151 type B dissection patients (mean age 62,2 Ϯ 12,6 years, 67% male) who underwent TEVAR were analyzed. True and false lumen diameter at baseline and follow-up were quantified. In 6 of 8 patients with pseudoaneurysm a complete follow-Up by CT was available which was compared with the other 143 patients: The angle between distal stent ending and the further aorta in patients without and with pseudoaneurysm was measured. Results: Eight of 151 patients developed a distal pseudoaneurysm after TEVAR. The incidence of development of pseudoaneurysm after TEVAR was 5.3 %. Seven patients were treated by distal extension of the stent graft, one denied reintervention. There was a significant difference in the angle between distal stent ending and the further aorta in patients without and with pseudoaneurysm (167,1°Ϯ 12,4 vs. 148,2°Ϯ 16,5, p Ͻ 0,05). In mean a pseudoaneurysm was diagnosed after 22,5 months (3,2-115,2 months). By TEVAR an aortic remodeling was achieved with a significant gain of the true lumen (1,6 Ϯ 0,8 cm vs. 2,9 Ϯ 0,5 cm, p Ͻ 0,001). Conclusions: Endovascular treatment in chronic type B dissection has a high technical success rate and low mortality. Pseudoaneurysm of the thoracic aorta following endovascular stent graft placement is a rare and potentially fatal condition.