A 76-year-old woman who had undergone 5 surgical procedures and chemotherapy for retro-peritoneal liposarcoma was found to have a right ventricular aneurysm by echocardiography, magnetic resonance imaging (MRI) and right ventricular cineangiogram. We decided that it was a false aneurysm because of communication with the right ventricle through a small orifice. At operation, aneurysm was not strongly adherent, so we closed the small orifice with a purse-string suture, and covered it with part of the wall of the aneurysm. Subepicardial aneurysm of the right ventricle was diagnosed by operative and pathological findings. The postoperative course was uneventful and she was discharged on the 15th postoperative day.

The number of surgical treatments for acute aortic dissection in octogenarians is increasing. They should return to their daily life as soon as possible after the operation without any complications. Some literature reported that minimally invasive cardiac surgery (MICS) helps quick recovery for the patients. We report a case of minimally invasive ascending aorta replacement for Stanford type A chronic thrombosed aortic dissection in an octogenarian to help quick recovery. An 81-year-old man was admitted in our hospital suffering from chest and back pain. Enhanced CT scan showed Stanford type A acute thrombosed aortic dissection. The diameter of ascending aorta was 45 mm and the diameter of false lumen was 7 mm. Therefore we decided on medical treatment for this patient according to the guideline. After four weeks medical treatment, ascending aorta was dilated to 49 mm and the false lumen also expanded to 9 mm. He underwent minimally invasive ascending aorta replacement to help quick recovery considering his age. He was discharged 11 days postoperatively without any complications. MICS offers a better cosmetic result, less blood loss, less pain, better respiratory function and quick recovery. Thus, minimally invasive operation for the elderly is also very satisfactory.