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The aim – to present the features of the clinical manifestations and course of two cases of embolism of the coronary arteries, in which fragments of left atrial (LA) tumors served as the embolic substrate. Materials and methods. This article discusses two cases of embolism with tumor fragments of the coronary arteries. In this case, the neoplasms were located in the left heart. Of particular interest is the fact that the clinical manifestations of embolism varied significantly, from severe pain requiring endovascular intervention, to minor discomfort lasting for several hours, without necessity of the inpatient treatment. Results. It should be noted that in both cases, a tumor lesion of the heart was detected several months after primary manifestation of the disease, namely, embolism of the coronary arteries. Echocardiography study made possible to get a correct diagnosis. In one case it was a routine examination 6 months after stenting of the coronary artery. The reason to perform echocardiography in another case was the result of electrocardiography, showing necrotic changes of the left ventricular posterior wall. In both cases, echocardiographic data prompted immediate surgery of the neoplasms. The structure of neoplasm samples obtained as a result of the surgery confirmed the possibility of coronary artery embolism with tumor fragments. Conclusions. Embolic complications may be a first manifestation of cardiac tumor. Fragmentation of the heart neoplasms may lead to damage of the cerebral and coronary arteries. Embolic complications can occur in young patients. Coronary artery embolism in cardiac tumors is associated with diverse clinical manifestations.

New methods of surgical treatment of rare tumours of heart Among benign heart tumors, except most frequently observed myxomas (89.6 % саses), non-myxomatous benign tumours, including fibromas (0.4 % саses) may be diagnosed. Two cases of tumours of rare localizations, i.e. in right atrium and left ventricle, are presented. In both cases low-invasive technics using videocameras, significantly facilitating procedures inside the heart, were used. Usage of low-invasive approaches with video assistance in cardiac surgery, contrary to standard sternotomy, significantly decreases intrasurgery trauma and blood loss, as well as pain syndrome after surgery. This facilitates early rehabilitation of the patients and decreases its terms. At the same time the complete spectrum of intracardiac surgical manipulations and methods is preserved. The development of this direction in cardiac surgery is very perspective, but the individualized approach to every patient is needed.

The aim – to analyze the frequency and nature of lesions of the valve apparatus, to evaluate the results of surgical correction of the affected valves in heart myxomas. Materials and methods. In one-centre study, during period from 01.01.1969 to 01.10.2020, 962 patients with morphologically verified primary heart tumors were observed. Myxomas of the heart were found in 856 (89.0 %) patients. The pathology of the valve apparatus in combination with cardiac myxomas was noted in 70 (8.1 %) patients. The volume and nature of valve damage differed and depended on size, consistency and localization of myxoma, the degree of its mobility, and the presence of areas of pronounced fibrosis and calcification on the tumor. Results. Surgical correction of lesions of valve structures was performed in 65 patients. In 5 patients, it was possible to remove tumor tissue from the valve apparatus, followed by prevention of disease recurrence without damaging valve and subvalvular structures. Surgical techniques included both plastic manipulation and valve replacement. The features of the long-term postoperative period in such patients include progressive valve dysfunction manifested by the progression of insufficiency due to further deformation of the valve apparatus. Conclusions. Alongside with myxoma removal, it is necessary to conduct a thorough examination of the valve apparatus and correction of valve damage by various methods, including plastic surgery and valve replacement, depending on the nature and severity of the damage.