On June 26, 2007, the Clinic for Cardiovascular Surgery at the German Heart Center Technical University in Munich successfully implanted a bioprosthetic valve via the apex of the heart within the framework of the CoreValve TAVR ReValving (Corevalve Inc., Irvine, CA, USA) clinical trial. The self-expanding aortic valve prosthesis is primarily designed for retrograde delivery across the aortic valve. The described transapical approach, however, now allows for treatment in those patients who have, for instance, no adequate "access" in the groin vessels due to peripheral vascular disease. Therefore, its feasibility must be considered as a major step in treating high-risk patients.

We present the case of a 73-year-old man with a 3-week history of recurrent exertional angina confirmed by exercise stress testing. The symptoms were caused by hemangioma situated between the pulmonary artery and the left auricle. The diagnosis was confirmed by ventriculography, coronary angiography, and CT-scanning. The tumor was completely removed through a midline sternotomy without extracorporeal circulation. Histology revealed the diagnosis of a cavernous hemangioma with endothelial lined vascular channels of varying size. The patient made an uneventful recovery and remained asymptomatic during follow up. Cardiac hemangioma are rare tumors of the heart that may cause angina by interfering with the coronary blood flow. Surgery is curative for most patients.

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