Cardiac blood cysts are rare benign neoplasms, usually involving the cardiac valves and are remnants of the Chiari network. They are usually detected in the first six months of life and rarely occur in children or adults. We report a 76-year-old male patient who was referred to the Imam Ali Hospital affiliated with Kermanshah University of Medical Sciences, Kermanshah, Iran, in 2018 with dyspnoea. Transthoracic echocardiography revealed a small patent foramen ovale (PFO) and a circumferential mobile cystic mass in the right atrium, with the impression of a tumour or thrombus. The patient underwent open-heart surgery with cardiopulmonary bypass to repair to PFO and remove the intra-atrial lesion. During surgical examination of the right atrial cavity, a blood cyst containing small stone-like structures on the coronary sinus valve of the right atrium was found. The post-operative course was uneventful and no recurrence of tumour was detected during six months of follow-up. To the best of our knowledge, this is the first reported case of a right atrial blood cyst with a few nodule-like stones in an adult with PFO in Iran and the second case in an adult with PFO worldwide.Keywords: Cyst; Coronary Sinus; Adult; Operative Surgical Procedure; Case Report; Iran.

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Congenital atresia of the left main coronary artery (LMCA) is an exceedingly rare phenomenon, and in the most of them, coronary artery bypass graft is required. We here describe a rare case of this anomaly that concomitantly was associated with supravalvar aortic stenosis and coronary–pulmonary fistula without the presence of conventional collateral circulation in a 16-year-old boy. The patient was admitted to our center with chest pain and dyspnea. Echocardiographic examinations showed supravalvar aortic stenosis with normal function of the aortic valve. Coronary angiography revealed atresia of LMCA with poorly developed left anterior descending coronary artery and well-developed circumflex coronary artery and diagonal artery that perfused by dominant and lengthy right coronary artery. The patient underwent coronary artery bypass grafting with repair of supravalvar aortic stenosis. The postoperative course was uneventful. The 6-month follow-up revealed normal diameter of the ascending aorta with symptomatic relief of preoperative chest complaint.

Right-ventricular outflow tract (RVOT) endocarditis is a very rare presentation of right-sided infective endocarditis (RSIE) by brucellosis. RSIE occurs most commonly in immune-suppressed cases and illicit drug abuser. The patients with RSIE and an incompetent immune system usually have a prosthetic foreign body in blood circulation such as catheter, pacemakers, or central venous lines and may be accompanied with tricuspid or pulmonary valve dysfunction. The most common site for RSIE is the tricuspid valve. We describe an exceedingly rare condition of RVOT endocarditis in a patient with brucellosis in which vegetation is attached to a muscle bundle of the RVOT. Despite appropriate antibiotic therapy, the general condition of the patient deteriorated and was finally scheduled for open-heart surgery. The mass was resected and the patient recovered uneventfully and was discharged on the 9th day of surgery with appropriate oral antibiotics.

Abstract- Metastatic involvement of cardiac valve and pericardium mimicking a cardiac valve pathology accompanied with cardiac tamponade is a rare phenomenon. These metastases commonly arise from the lymphoreticular system, the pulmonary system, and breast. Metastatic spread of breast carcinoma to the cardiac valve is exceedingly rare, and only two case reports have been detected in English literature so far. We report a rare case of a patient with adenocarcinoma of the breast, which presented with severe mitral valve regurgitation and pericardial effusion which was managed urgently with mitral valve replacement. Our case shows the probability of combined metastatic pericardial and valve involvement in patients with breast adenocarcinoma. The patient was treated with mitral valve replacement and intrapericardial infusion of cisplatinum drug to control possible recurrent effusion.