Cardiac undifferentiated pleomorphic sarcoma (UPS) associated with fever and inflammatory response is an extremely rare condition. Herein, we report a rare case of cardiac UPS with unusual clinical presentation and inflammatory response. A 67-year-old male complaining of progressive dyspnea and intermittent fever of unknown cause was referred to our hospital for surgical resection of a left atrial mass. Laboratory analysis showed leukocytosis (26 × 10³/μL) and high C-reactive protein (CRP) levels (155.4 mg/L). Hemoculture tests and urine analysis were negative for infection. A contrast chest computed tomography revealed a mass measuring 5.5 × 4.5 cm, occupying the left atrium cavity. The patient underwent surgical excision of the mass, however, surgical margin of the resected tumor could not be evaluated, due to the multifragmented nature of the resection specimen. Postoperative CRP and leukocyte levels normalized, highlighting the relationship between the tumor and the inflammatory status. Early diagnosis is crucial for a proper management and favorable outcome, enabling patients to undergo chemotherapy and achieve complete surgical resection.

Background and Clinical Significance: Primary cardiac tumors are among the rarest types of tumor, and until the mid-20th century, they were diagnosed only post-mortem or during other surgical interventions. With the rapid evolution of cardiovascular imaging and the widespread use of echocardiography, the incidence of cardiac fibroelastoma has increased, though it remains one of the rarest primary cardiac tumors. Papillary fibroelastoma is a benign primary cardiac tumor that develops from endocardial tissue, is usually solitary, and can have multiple locations, with the pulmonary valve being one of the rarest sites. The symptoms and complications depend on the tumor’s location, ranging from asymptomatic patients to cerebral ischemic embolism or pulmonary embolism. We analyzed the electronic databases PubMed, Web of Science, and Cochrane and conducted a systematic review of pulmonary valve papillary fibroelastoma (PVPF). Additionally, we included a case from the Adult and Pediatric Cardiovascular Surgery Clinic in Targu Mures. Case Presentation: We present the case of a 58-year-old patient who complained of exertional dyspnea. A transthoracic echocardiography (TTE) revealed a tumor mass attached to the pulmonary valve and coronary angiography identified severe coronary lesions. Following discussions within the Heart Team, surgical myocardial revascularization and tumor excision were decided upon due to the thromboembolic risk. Histopathological examination confirmed the diagnosis of papillary fibroelastoma. The postoperative course was uneventful, with an improvement in dyspnea. The mean age of the patients was 60 years, with half being men (n = 26, 50%). Regarding symptoms, 34% (n = 18) of cases were incidentally identified, while over 30% (n = 17) presented with dyspnea. Pulmonary embolism (PE) was reported in only two patients, and the most common associated comorbidities included high blood pressure (HBP) in 33% (n = 16) and dyslipidemia in 18%. Tumor size ranged from 0.7 cm to 3 cm with the initial benign cardiac tumor; its occurrence in the pulmonary valve remains exceedingly rare. Due to its frequent overlap with other cardiac pathologies, the clinical presentation is often a nonspecific diagnosis or suspicion of a tumor predominantly established via transthoracic echocardiography in 62% of patients. From a surgical perspective, 63% (n = 33) underwent tumor resection with valve sparing, 25% (n = 12) required pulmonary valve repair, and three patients necessitated pulmonary valve replacement. Conclusions: Although the incidence of papillary fibroelastoma is increasing, making it the most common, there is a need to highlight the indispensable role of echocardiography in diagnosis. Although papillary fibroelastoma is benign, surgical intervention is recommended, particularly in symptomatic patients, or if the tumor exceeds 1 cm in size, exhibits increased mobility, or is present alongside other cardiac surgical procedures.

Introduction: Coarctation of the aorta represents a narrowing of the thoracic aorta. Hypertensive patients with blood pressure differences ≥20 millimetres of mercury have an indication for surgical or interventional treatment. Implantation of a covered stent became the preferred therapy for the management of this pathology in adolescents/adults. Case report: We report the case of a 14-year-old male sportsman, who presented in the emergency room with headache, dizziness, and tinnitus. The clinical exam revealed blood pressure differences between the upper and lower limbs of up to 50 mmHg. Based on the clinical and paraclinical data, we established the diagnosis of coarctation of the aorta and severe secondary arterial hypertension. The case was discussed by a multidisciplinary team and accepted for covered stent implantation. The 24 h blood pressure Holter monitoring after the procedure indicated the persistence of stage I arterial hypertension. Conclusions: Coarctation of the aorta is a congenital cardiovascular anomaly with high morbidity and mortality rates. Arterial hypertension, heart failure, and aortic dissection are complications of this pathology, some of them being sometimes direct consequences of secondary hypertension. Periodic cardiology follow up after the procedure is mandatory to assess the hemodynamic response, to identify potential complications, and to stratify the cardiovascular risk.

Background: Primary cardiac tumors are exceedingly rare, with myxomas representing the most common benign type among these tumors, predominantly located in the left atrium. Biatrial involvement is an exceptional presentation, reported in less than 2.5% of cases. The terms bilateral and biatrial atrial myxoma are often confused and used interchangeably. We present a rare case of atrial myxoma involving both chambers, resected via a minimally invasive endoscopic approach, accompanied by a literature review. Case Presentation: A 52-year-old male with a three-month history of progressive fatigue and exertional dyspnea was found, on transthoracic echocardiography and cardiac MR, to have two intracardiac masses affecting both atria. Intraoperative transesophageal echocardiography confirmed the presence of mirror-image myxomas attached to the interatrial septum, in the absence of any septal defect. The tumors were excised en bloc, including the septal attachment, using a minimally invasive endoscopic approach. Histopathological examination confirmed the diagnosis of atrial myxoma, and the postoperative course was uneventful. Conclusions: Bilateral and biatrial atrial myxomas are exceedingly rare forms of cardiac tumors. In many cases, the first clinical manifestations may arise from cerebral or peripheral embolic events or from pulmonary thromboembolism. For this reason, screening echocardiography may be useful, particularly in cases of familial myxoma. Transthoracic and transesophageal echocardiography, combined with careful inspection of all cardiac chambers, play a crucial role in preventing recurrence by detecting small or overlooked tumor fragments. The minimally invasive endoscopic approach offers a safe and effective surgical option for biatrial myxomas, providing excellent visualization and facilitating thorough exploration of the cardiac cavities.

Background: Autologous vascular arterial or venous graft are not available in 10-40% of patients, due to vascular pathologies, and the utility of decellularized biological scaffolds would be a solution for those cases. The purpose of this research was to obtain a functional acellular xenograft, prior to in-vivo testing as a vascular graft in an experimental animal. Materials and method: Two batches of carotid vasculo-nervous bundles were collected from porcine models from a local slaughterhouse. The arterial grafts were dissected and isolated, obtaining carotid arteries with a caliber of 5–6 mm and a length of approximately 10–12 cm. Two decellularization protocols were used, immersion (n = 10) and perfusion (n = 9). The resulting grafts underwent histological examination, DNA analysis, electrophoresis and spectrophotometry. Results: Due to severe tissue damage and friability, the batch that was decellularized using perfusion was not examined. The histological examination of grafts stained with hematoxylin-eosin and DAPI highlighted the absence of nuclei. Spectrophotometry revealed a 90% decellularization, and electrophoresis of revealed the migration band of the material extracted from the fresh tissue, as well as the absence of migration bands in the case of the material extracted from decellularized tissues. Conclusion: We successfully used the immersion protocol to obtain a functional acellular vascular graft, in contrast to perfusion decellularization, where intraluminal high pressures damage the extracellular matrix.