Background: Primary cardiac myxofibrosarcoma is quite rare and commonly arises in the left atrial. Myxofibrosarcoma is an aggressive and has high mortality because of high rate of recurrence. It is considered that complete surgical resection is important but effective treatment options are not established. Case presentation: We report a case of 75-year-old woman who developed myxofibrosarcoma spreading to left atrial and pericardium. To prevent sudden death by obstruction of mitral valve, we performed surgical resection of the tumor. The patient developed brain metastasis at two months after surgery, and eventually passed away due to brain hemorrhage at three postoperative months. Conclusion: In this report, we described a very rare case of primary cardiac myxofibrosarcoma located not only in the left atrial but also in the pericardium. To prevent the recurrence of myxofibrosarcoma, combination of surgery, radiotherapy and chemotherapy should be needed.

A median full-sternotomy should be avoided in patients with tracheostoma because of the risk of sternal infection and mediastinitis. Recently, there have been some reports on cardiac surgery through a partial sternotomy for combined valvular disease. We present a case in which aortic valve replacement and mitral valve replacement and tricuspid valve annuloplasty were successfully performed through a reverse L shape partial sternotomy. This approach minimizes an incision and secures a distance between the incision and tracheostoma.

Recently, there have been some reports that cone reconstruction can be performed in the repair of Ebstein's anomaly with acceptable result on a child. On an adult with Ebstein's anomaly, optimal surgical indication and choice of the operative procedure are controversial. A man in his seventies was diagnosed with Ebstein's anomaly incidentally during preoperative examination of severe aortic regurgitation. We performed aortic valve replacement and cone reconstruction, because his tricuspid regurgitation was moderate. There was no severe complication and he was discharged. No sign of recurrence have been observed after 4 months follow up. We present a case in which cone reconstruction and aortic valve replacement were successfully performed on an adult patient diagnosed with Ebstein's anomaly and severe aortic regurgitation.