[Mycotic distal arch aneurysm successfully operated through L-incision approach].

A 70-year-old female who had undergone pancreato-duodenectomy 1 month before, presented with back pain. Computed tomography (CT) revealed a saccular aneurysm in the distal aortic arch (40 mm in diameter) and she was referred to our department. Despite proper antibiotic treatment, CT revealed progressive enlargement of the aneurysm and operation was performed. The aneurysm was treated by debridement of the infected aortic tissue and in situ replacement with a rifampicin-soaked vascular prosthesis through L-incision approach. After surgery, antibiotics were administrated intravenously for 1 month, followed by oral antibiotics. The patient is doing well 1 year after the operation.

Ossifying cardiac myxoma with neovascularity.

We report a 64-year-old man with ossifying cardiac myxoma which radiographically demonstrated visible calcification. A lateral chest radiograph showed abnormal calcification in the cardiac shadow. Two-dimensional and transesophageal echocardiography revealed a heterogeneous mass with a hyperechoic lesion in the left artium. A coronary angiogram showed a neovascular formation extending from the coronary arteries to the tumor. The resected tumor was composed of round or spindle shaped cells with myxoid stroma, accompanied by extensive calcification and ossification containing fatty and hematopoietic marrow tissue. Although a left atrial calcified myxoma is less common than a right sided myxoma, and such radiographically detectable calcified tumors are rare, the presence of radiographic visualized calcification in the cardiac shadow should be ruled out for left as well as right atrial myxomas.