Premature atrial complexes are frequent among patients after heart transplantation. We herein report on the successful use of ivabradine in a 15-year old patient who exhibited marked palpitations caused by atrial premature complexes after orthotopic bicaval heart transplantation.

After right ventricular outflow tract obstruction reconstruction for CHD, surgical pulmonary valve replacement, or transcatheter pulmonary valve replacement may be performed if complicated by moderately severe or severe right ventricular outflow tract dysfunction. However, for patients whose anatomy is not suitable for transcatheter pulmonary valve replacement, surgical pulmonary valve replacement is the only option, but it has a higher rate of perioperative complications and longer hospitalisation for patients. In two cases of severe transcatheter pulmonary valve replacement in which percutaneous pulmonary valve implantation could not be performed directly due to the presence of a large right ventricle, a significant decrease in right ventricular function, and significant widening of the pulmonary arteries, we used a new hybridisation procedure to partially fold and reduce the diameter of the significantly widened pulmonary artery trunk without cardiopulmonary bypass by surgically opening the thorax in a median way, and then successfully implanted a percutaneous self-expanding pulmonary valve valve, with good immediate results in the postoperative period. The postoperative recovery was rapid and the recent results were excellent.

This case report describes a rare incidence of innominate artery compression syndrome in a 5-month-old infant, presenting with severe respiratory symptoms. It highlights the diagnostic challenges, the detailed imaging techniques used, and the surgical intervention that resulted in a successful resolution of symptoms, emphasising the importance of early recognition and intervention in paediatric vascular anomalies.

Transcatheter device closure of a large perimembranous ventricular septal defect with left-to-right shunt was attempted with an antegrade transvenous approach and a conventional arteriovenous loop facilitated, both of which were unsuccessful. We succeeded with an indigenous technique of advancing the delivery sheath towards the left ventricular apex from the venous side with the help of a cut pigtail, keeping the arteriovenous loop.

Middle aortic syndrome is rare cause of secondary hypertension, typically manifesting in childhood or early adolescence. It involves obstructive narrowing of the aorta, often occurring in the distal thoracic and abdominal aorta and its major branches. While the exact cause of middle aortic syndrome is not fully understood, it has been linked to hereditary genetic conditions such as Williams syndrome. This case report describes a 16-year-old female with Williams syndrome who presented with abdominal pain and hematochezia. CT angiography revealed moderate narrowing of the abdominal aorta, consistent with a diagnosis of middle aortic syndrome.

A newborn with right atrial isomerism, single-ventricle physiology, supracardiac total anomalous pulmonary venous connection, and pulmonary atresia underwent vertical vein stenting, resulting in ductus arteriosus compression. Subsequent ductal stenting restored patency, preventing haemodynamic compromise and ensuring survival. This case highlights the risk of secondary ductal obstruction in vertical vein stenting and the importance of early recognition and intervention.

A preterm newborn (36 weeks, 2000 g) was diagnosed with hepatic hemangiomas during routine screening. Echocardiography revealed cardiac hemangiomas and pericardial effusion, requiring drainage. Propranolol was initiated for hepatic involvement. Over three years, cardiac and hepatic hemangiomas regressed without complications. This rare coexistence highlights the importance of multidisciplinary management and long-term follow-up.

The dominant focus on rheumatic aetiology of mitral regurgitation (MR) often overshadows other causes. This challenges optimal management when the aetiology is non-rheumatic, as exemplified below in an 8-year-old girl, hailing from Uganda, who was diagnosed and managed as rheumatic MR with unusually elevated and persistent systemic inflammatory state with chronic renal dysfunction disproportionate to her cardiac status. Further workup led towards the possibility of early onset systemic lupus erythematosus (SLE). The valvular involvement in SLE closely resembles rheumatic heart disease (RHD). A high level of clinical suspicion is essential for diagnosing childhood-onset SLE. Coexistence of RHD and SLE is extremely rare and has significant implications for management.

Cardio-facial-cutaneous syndrome is a rare genetic disorder that typically presents with a combination of CHDs, distinctive facial features, and cutaneous abnormalities. Cardio-facial-cutaneous syndrome is usually caused by a genetic change in the BRAF gene but can also be due to genetic change in the MAP2K1, MAP2K2, or KRAS genes. It is an autosomal dominant condition, but most cases are not inherited, due to new genetic change that occurs in the formation of the egg or sperm or shortly after fertilisation. It has been seen previously in the literature where the patient required a mitral valve replacement because of insufficiency. In this case report, we describe a patient with cardio-facial-cutaneous syndrome who also presented with mitral valve prolapse. This rare association expands the spectrum of cardiovascular manifestations in cardio-facial-cutaneous syndrome and highlights the importance of comprehensive cardiovascular evaluation in these patients.