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Introduction Cardiac haemangioma (CH) is an extremely rare type of benign heart tumor, with prevalence only 2.8% of all primary cardiac tumors. The symptoms of tumor are often nonspecific. Preoperative screening and diagnosis are based on imaging examinations. Radical surgical resection is indicated in symptomatic patients. Case presentation We report on a case of an incidentally found tumor located on the right-sided epicardium that was successfully removed with the totally endoscopic surgery (TES) and the concomitant use of cardiopulmonary bypass (CPB). Discussion Excision of these tumors has been described through a median sternotomy approach. In recent years, TES has grown in popularity with many advantages. On the other hand, on-pump beating-heart (ON–BH) technique has been appreciated as a superior myocardial preservation method. The combination of these procedure provides clinical benefits and patient preferences. Conclusion Totally endoscopic resection of CH under ON-BH is a safe, effective procedure, which can be adopted in similar cases., Highlights • Surgical resection of cardiac haemangioma is the first-line treatment. • Minimally invasive cardiac surgery has gradually replaced the sternotomy approach. • On-pump beating-heart technique provides significantly lower morbidity and mortality. • Totally endoscopic resection of tumor under a beating-heart is safe, effective.

Thoracoscopic subxiphoid approaches, such as the single-port thymectomy (SPT) and dual-port thymectomy (DPT) approaches have been demonstrated to have several advantages compared with the traditional median sternotomy approach or the bilateral or hemilateral video-assisted thoracoscopic (VATS) approach. However, SPT and DPT are technically demanding for novice surgeons since they require precise concomitant manipulation of surgical instruments and the thoracoscope within the same port, without interference. To overcome these limitations, we have developed a new method, termed DPT plus one (DPT+1), to facilitate separation of the surgical access ports and camera port by adding another intercostal port to the DPT approach. Our method is easy and safe not only for simple mediastinal resection but also for extended thymectomy.

Although they comprise a small number of primary tumors of the heart, papillary fibroelastomas (PFEs) are the second most common type of benign cardiac tumor. PFEs of the right heart are uncommon, and those arising from the right-ventricular (RV) wall are extremely rare, with only a handful of reported cases in the literature. Removal of these tumors has been described, primarily through a median sternotomy approach, with only one report of using a right-sided mini-thoracotomy technique. The advantages of endoscopic robotic-assisted cardiac surgery have been demonstrated and described extensively. We report on a case of an incidentally found PFE in the RV that was successfully removed with a totally endoscopic robotic-assisted approach. The focus of our report is on the uniqueness of both the right-sided nonvalvular PFE and the treatment with a robotic totally endoscopic surgical approach.

A three-year-old child developed a large tracheo-oesophageal fistula secondary to a button battery being lodged in the upper oesophagus for 36 hours. The diagnosis was confirmed with a contrast swallow. Operative access was gained through a combined right cervical incision and complete median sternotomy. Repair of the fistula required a segmental resection of both the trachea and oesophagus followed by primary anastomosis.

We report the usefulness of a median sternotomy approach for the surgical treatment of residual aortic gradients or recoarctation and aortic aneurysms. This series confirms that excellent surgical results can be obtained in this technically challenging group of patients needing postcoarctation repair.