A 64-year-old woman was admitted to our hospital with sudden chest and back pain. Computed tomography showed acute type A aortic dissection complicated with malperfusion of the left main coronary artery (LMT). Immediately after the CT, the patient went into sudden shock. Electrocardiogram showed ventricular tachycardia and ventricular fibrillation. Percutaneous cardio-pulmonary support was administered and coronary arteriogram (CAG) was performed. CAG revealed LMT stenosis and intravascular ultrasound showed mobile intimal flap at the LMT. Percutaneous coronary intervention of the LMT was performed. The patient recovered from shock and was treated with ascending aorta replacement with CABG. The patient was discharged from the hospital without any major complication.

A 76-year-old woman, suffering from rapidly worsening dyspnea, and general fatigue was referred for evaluation and treatment of cardiac tumor. Echocardiography and computed tomography revealed a large tumor occupying the right atrium and inferior vena cava. We performed partial resection with cardiopulmonary bypass, in order to improve hemodynamics. The pathological examination suggested malignant lymphoma, diffuse large B-cell type. The patient was treated with cyclophosphamide, cyosine, arabinoside, etoposide, dexamethasone and rituximab (CHASER) postoperatively and gained complete response.

A 9-year-old boy with multisaccular thoracic aortic aneurysm associated with coarctation of the aorta underwent definitive repair under partial cardiopulmonary bypass. The operation consisted of resection of the aneurysm and reconstruction of the descending aorta. Aortic reconstruction was done without an artificial graft, and extended end-to-end anastomosis was performed successfully. He has been doing well and there was no significant restenosis at the repair site 5 years after the operation. Some authors reported that untreated coarctation of the aorta frequently developed aneerysm, which usually has multisaccular lesions. Surgical strategy of aortic reconstruction for coarctation of the aorta in boyhood should be decided prudently to avoid postoperative complications.

We encountered a case of pseudoaneurysm of the ascending aorta, aortic stenosis and regurgitation, and infected popliteal aneurysm discovered 24 years after cardiac operation. A 34-year-old male who had undergone radical operation for subaortic stenosis at age 10 had infectious endocarditis. Pseudoaneurysm of the ascending aorta and aortic stenosis and regurgitation were noticed after diagnosis of a popliteal aneuyrsm, and operation was performed in two stages. Resection of the popliteal aneurysm, direct suturing of the entry as well as resection of the pseudoaneurysm of the ascending aorta, patch plasty of the defect and replacement of aortic valve were performed with satisfactory results.