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A papillary fibroelastoma at the apex of the left ventricle is benign and rare. Over the last two decades, minimally invasive cardiac surgery has been developed to be used under either direct vision via a small skin incision or endoscopic vision with or without robotic assistance via a very small skin incision. We report a case of three-dimensional thoracoscopic resection. A 68-year-old female with hypertension and paroxysmal atrial fibrillation had a growing mass in the left ventricular. An echocardiogram demonstrated a smooth and mobile mass with a diameter of 15 mm at the apex of the left ventricle. An enhanced magnetic resonance imaging revealed a cardiac tumor. Since she had suffered from diffuse mild cerebral infarctions, we performed three-dimensional thoracoscopic resection of the tumor which revealed to be left ventricular papillary fibroelastoma on histological examination. Her postoperative course went well without any complications. Using only three-dimensional thoracoscopy, we performed the cardiac surgery easily and shortened the operative time, including the preparation time, resulting in a satisfactory cosmetic result.

Background：Cor triatriatum is a rare congenital cardiac anomaly, in which the left atrium or right atrium is separated by an abnormal fibromuscular membrane with one or more restrictive orifices. This condition typically presents in infancy or early childhood and can be associated with other cardiac anomalies.Case presentation：A 75-year-old woman was admitted for exertional dyspnea with moderate aortic and mitral stenosis. As cor triatriatum was revealed by a computed tomography and echocardiography, she was referred to our department for surgery. Aortic valve replacement, mitral valve replacement and excision of the membranous septum in the left atrium was performed. This report presents an incidental findings of cor triatriatum with aortic stenosis, moderate mitral stenosis in septuagenarian.Conclusion：We encountered a rare case of cor triatriatum with aortic stenosis and mitral stenosis in septuagenarian. She was incidentally diagnosed by rheumatic aortic and mitral stenosis which had advanced to moderate level.