A 38-year-old woman was admitted due to an abnormal ECG and dyspnea on effort. Transoesophageal echocardiography and cardiac computed tomography (CT) showed severe aortic regurgitation (AR) due to pentacuspid aortic valve, which consisted of 4 relatively equal cusps and 1 larger cusp. Mild mitral regurgitation, atrial septal defect (ASD) and coronary-pulmonary artery fistula were complicated for her. She underwent aortic valve replacement, mitral valve annuloplasty, direct closures of ASD and coronary-pulmonary artery fistula. The pathophysiology of the resected aortic valve showed 4 equal size cusps and a large one with mild myxomatous change. Aortic valve regurgitation due to pentacuspid aortic valve is extremely rare and there was little report concerning it in the literature. We reported the surgical repair of this rare case of severe AR due to pentacusupid aortic valve.

A 70-year-old man receiving neoadjuvant chemotherapy (5FU+CDDP) for esophageal cancer was transferred to our hospital for the treatment of asymptomatic thrombus in the ascending aorta. Enhanced computed tomography revealed a low-density mass of 34×16 mm in diameter on the posterior surface of the ascending aorta. We performed thrombectomy and suture plication of the aortic intima under hypothermic circulatory arrest. Intraoperative epiaortic echo showed the mass was floating in the aorta. The patient was discharged from the hospital on the 18th postoperative day. Most patients with aortic thrombus are diagnosed under conditions of peripheral embolism. Asymptomatic thrombus in the ascending aorta is extremely rare. We herein report a case of thrombectomy for asymptomatic thrombus in the ascending aorta.