Background: Ascending aortic aneurysm is a common clinical disease, whereas the aneurysm at the incision of ascending aorta after valve replacement has not been reported. Aims: We report a case of giant ascending aortic incision aneurysm requiring surgical correction after double valve replacement. Materials & Methods: A 45‐year‐old male was referred to our department with dyspneic respiration after exercises for 1+ months, having previously undergone a mitral and aortic valve bivalve replacement 15+ years ago. The parasternal long-axis section of transthoracic echocardiography provided that the diameter of ascending aorta was thickened( 59mm). Computed tomography angiography (CTA) of the aorta showed a localized anterior protrusion aneurysmal of the ascending aorta with a diameter of approximately 69 mm, and the tube wall was severely calcified. Results: Under cardiopulmonary bypass, the large aneurysm was incised and the artificial blood vessels were replaced. The patient achieved an uneventful postoperative recovery with no significant complications. Discussion: Ascending aortic incision aneurysm has the same treatment regimen as ascending aortic aneurysm although it’s extremely rare. Conclusion: Open surgery was indispensable in this case owing to the large aneurysm and the condition liable to rupture.

A 44‑year‑old male patient was referred to our department with unremarkable physical examination and laboratory data due to a mass which was incidentally found in the right atrial during a routine examination.Transthoracic and transesophageal echocardiography revealed a 46×30 mm, well-delimited, non-mobile mass in the superior portion of the right atrium. Besides the intracardiac mass, another low density was detected in adjacent pericardial cavity at cardiac computed tomography ;he extracardiac mass appeared to be caused by invasive growth from the intracardiac mass.An operation was performed through right anterolateral minithoracotomy with the patient under hypothermic cardiopulmonary bypass. During operation, it was found that the surface of the right atrium was covered by an adipose mass (30×40 mm; Fig. 2A). Intracardiac mass also showed yellow adipose tissue (40×50 mm; Fig. 2B). Both parts of the mass infiltrated the myocardium. The mass was resected completely; and right atrium was reconstructed by using bovine pericardium pad. After the operation, the pathology confirmed the both intracardiac and extracardiac tissues as lipoma; transthoracic echocardiogram showed the atrial mass was removed completely and the left ventricular ejection fraction was normal . The patient’s postoperative course was uneventful and he was discharged home after 7 days.