A 76-year-old man who underwent thoracic endovascular aortic repair (TEVAR) of an early chronic phase of Stanford type B dissection developed a 71 mm distal aortic arch aneurysm in conjunction with the migration of its proximal end over 9 years of follow-up. The proximal end of the graft had migrated 7 cm distal to the takeoff of the left subclavian artery. The patient underwent total arch replacement with an open stent graft which was connected with the TEVAR graft. He was discharged home 15 days after surgery without complications.

A 52-year old woman was referred to our hospital because of abdominal pain and restlessness. A chest contrast-enhanced CT showed huge pericardial effusion and intraluminal defects in the main pulmonary artery. We could not make a diagnosis based on the cytology of the pericardial effusion and histopathology of the mass with a sample taken by a catheter. Therefore, we undertook biopsies of the mass by median sternotomy, which led to the diagnosis of pulmonary intimal sarcoma. The tumor resection was performed to release the right ventricular outflow stenosis. We tried to resect the tumor as much as possible, and reconstructed the pulmonary artery and aortic root. She was discharged to home and survived 5 months after surgery.