Intrapericardial teratomas are unusual tumors that often cause cardiorespiratory distress and might be lethal in the newborn. We described a case of neonate who was successfully treated by emergency surgery. A 5-day-old female infant was referred for further evaluation of a fever and progressive cardiorespiratory distress. Chest X-ray showed a widened central silhouette. Echocardiogram and chest CT scanning demonstrated a 59×40mm mediastinal mass and the mass effect or massive pericardial effusion cause cardiac tamponade. After sternotomy, the tumor was found to have arisen from the anterior surface of the aortic root and 30ml of serosanguinous fluid were aspirated. The tumor was completely removed without any difficulty with cardiopulmonary bypass standby. The postoperative course was uneventful. Histologically, this tumor appeared to be a mature teratoma. The surgical resection was lifesaving.

The ascending aorta and aortic arch were replaced in a 72-year-old woman with Stanford type A aortic dissection. Preoperative three-dimensional computed tomography (3D-CT) revealed that the anatomy of an isolated left vertebral artery was abnormal. After hypothermic circulatory arrest, a 12-mm sealed graft was connected to the island-shaped arch under retrograde cerebral perfusion, followed by antegrade cerebral perfusion via a branch of the graft. The main graft was distally anastomosed, and the graft of the cerebral arteries was subsequently anastomosed on the main graft under continuous cerebral and systemic perfusion. The patient tolerated all procedures well without cerebral or bleeding complications, and was discharged 18 days after surgery. This technique was useful for island reconstruction, even with abnormal cerebral arteries and bleeding control of this anastomosis was simple compared to the conventional island technique.