Primary cardiac angiosarcoma is a relatively rare tumor with early metastasis and poor prognosis. Radical resection of the primary tumor remains the primary approach for the optimal survival of patients with early-stage cardiac angiosarcoma without evidence of metastasis. This case involves a 76-year-old man with symptoms of chest tightness, fatigue, pericardial effusion, and arrhythmias who achieved good results after surgery to treat the angiosarcoma in the right atrium. In addition, literature analysis showed that surgery remains an effective way of treating primary early angiosarcoma.

Background: Primary cardiac angiosarcoma is a rare cardiac tumor. Most of them grew in the right atrium, often invading the superior vena cava and pericardium. The clinical symptoms of majority patients may present right heart failure, superior vena cava obstruction, and even pericardial tamponade. Case presentation: In this case report, we presented a 76-year-old man presented with chest tightness, fatigue, pericardial effusion, and arrhythmia. The transthoracic echocardiography (TTE) showed that a mass in the right atrium. Histopathology and immunohistochemistry confirmed the diagnosis of angiosarcoma. The patient was discharged from hospital after surgery. Conclusions: For the patients with early stage cardiac angiosarcoma without evidence of metastasis, radical resection of the primary tumor remains the most important approach for optimal survival.

Objective The optimal treatment of patients with severe aortic stenosis (AS) and complex coronary artery disease (CAD) remains controversial. We conducted a meta-analysis to investigate outcomes of transcatheter aortic valve replacement (TAVR) with percutaneous coronary intervention (PCI) versus surgical aortic valve replacement (SAVR) with coronary artery bypass grafting (CABG). Methods We searched PubMed, Embase, and Cochrane databases from its inception up to 17 December 2022 for studies that assessed TAVR + PCI versus SAVR + CABG in patients with AS and CAD. The primary outcome was perioperative mortality. Results Six observational studies including 135,003 patients assessing TAVI + PCI ( n = 6988) versus SAVR + CABG ( n = 128,015) were included. Compared to SAVR + CABG, TAVR + PCI was not significantly associated with perioperative mortality (RR, 0.76; 95% CI, 0.48–1.21; p = 0.25), vascular complications (RR, 1.85; 95% CI, 0.72–4.71; p = 0.20), acute kidney injury (RR, 0.99; 95% CI, 0.73–1.33; p = 0.95), myocardial infraction (RR, 0.73; 95% CI, 0.30–1.77; p = 0.49), or stroke (RR, 0.87; 95% CI, 0.74–1.02; p = 0.09). TAVR + PCI significantly reduced the incidence of major bleeding (RR, 0.29; 95% CI, 0.24–0.36; p < 0.01) and length of hospital stay (MD, −1.60; 95% CI, −2.45 to −0.76; p < 0.01), but increased the incidence of pacemaker implantation (RR, 2.03; 95% CI, 1.88–2.19; p < 0.01). At follow-up, TAVR + PCI was significantly associated with coronary reintervention (RR, 3.17; 95% CI, 1.03–9.71; p = 0.04) and a reduced rate of long-term survival (RR, 0.86; 95% CI, 0.79–0.94; p < 0.01) Conclusions In patients with AS and CAD, TAVR + PCI did not increase perioperative mortality, but increased the rates of coronary reintervention and long-term mortality.