Infection of surgical wounds with acid-fast bacilli, including tubercle bacilli, is rare, and is poorly described in the literature. We present the case of a 74-year-old male who developed a sternal wound infection after cardiac surgery due to Mycobacterium tuberculosis complex, diagnosed post-mortem. SARS-CoV-2 infection contributed to worsened clinical conditions and surgical site infection. A high degree of suspicion to avoid unnecessary treatments and progression to severe disease with dismal prognosis is necessary in these types of infections.

Bicuspid aortic valves (BAV) can be associated with aortopathy and coronary anomalies. We report the case of a 60 year-old woman undergoing surgery for severe aortic stenosis due to BAV and an ascending aortic aneurysm. During the procedure, an uncommon anomalous origin of the left main coronary artery from the posterior commissure with intramural takeoff of the left coronary artery was found. Routine pre-operative coronary angiography had failed to identify this anomaly. To avoid ischemic events or left main coronary lesions, we placed the aortic bioprosthesis by respecting the commissures, not to occlude the anomalous coronary ostium. The association of BAV, aortopathy and coronary anomalies is a rare finding. Awareness of the anatomy of the coronary arteries in patients with BAV should be considered mandatory to avoid catastrophic consequences and to select the appropriate surgical procedure.

Heart failure symptoms, in particular dyspnea, may be difficult to frame in a patient with cancer. We report the case of an oncological patient whose dyspnea could have been attributable to various causes and whose management was challenging in the context of the coronavirus disease-2019 pandemic. ( Level of Difficulty: Beginner. )