Giant aortic aneurysm is defined as aneurysm in the aorta greater than 10 cm in diameter. It is a rare finding since most patients will present with complications of dissection or rupture before the size of aneurysm reaches that magnitude. Etiological factors include atherosclerosis, Marfan’s syndrome, giant cell arteritis, tuberculosis, syphilis, HIV-associated vasculitis, hereditary hemorrhagic telangiectasia, and medial agenesis. Once diagnosed, prompt surgical intervention is the treatment of choice. Although asymptomatic unruptured giant aortic aneurysm has been reported in the literature, there has not been any case of asymptomatic giant dissecting aortic aneurysm reported in the literature thus far. We present a case of a 62 year old man with a 14 cm of diameter aneurysm of the ascending aorta and aortic arch without impact on the aortic root.

Endocarditis isolated from the pulmonary valve is not that common. It has a clinical appearance of right heart endocarditis, with potential pulmonary septic emboli. We report a case of a 14-years-old girl treated for isolated pulmonary valve endocarditis and pulmonary stenosis in which the destruction of the pulmonary valve required the use of a pulmonary homograft for RVOT reconstruction.

A case of a 49-year-old man with a history of buprenorphine-substituted heroin was admitted for acute heart failure after three months of bioprosthetic aortic replacement to treat infective endocarditis. Transthoracic echocardiography (TTE) showed a left ventricular ejection fraction (EF) was 35% and a periprosthetic mass with an aorto-ventricular fistula. Thoracic computed tomography revealed a left ventricular outflow tract (LVOT) pseudoaneurysm measuring 69 x 45 mm that compressed left anterior descending (LAD) artery with downstream myocardial ischemia. Patient was treated by an urgent surgery, including an exclusion of the pseudoaneurysm, a left ventricular reconstruction surgery and a bioprosthetic aortic replacement. Patient went through a difficult postoperative period. Finally, he was safely discharged with a low EF (34%) from hospital to rehabilitation center with a Life vest. This case spotlights a rare devastating complication of a LVOT pseudoaneurysm compresses LAD artery and how surgery could decompress the false aneurysm and stabilize ischemia.

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Cardiac papillary fibroelastoma is a rare, benign, slow –growing tumor of endocardium that my have a malignant propensity for live-threatening complications. The histogenesis remains controversial; an iatrogenic origin has been suggested. Localization in the left ventricular outflow tract is extremely rare. We describe a case of left ventricle fibroelastoma in patient with previous chest radiotherapy, seeming to support the iatrogenic hypothesis.