Early postoperative arrhythmias are a known complication of cardiac surgery. It is unusual, however, to encounter postoperative junctional and ectopic atrial tachycardias in the same patient. We describe our experience with a 2-year-old girl who suffered both these tachycardias after repair of a ventricular septal defect, the abnormal rhythms being controlled solely with intravenous administration of amiodarone.

The syndrome of twin-to-twin transfusion is known potentially to be associated with the development of right ventricular obstruction, albeit rarely at supravalvar levels, in the recipient twin. We report the case of a recipient twin with diffuse hypoplasia and calcification of the pulmonary arterial tree, confirmed by postnatal thoracic angioscan. When aged 2 years, the child was moderately symptomatic with mild cyanosis, in spite of suprasystemic right ventricular systolic pressure as revealed by follow-up echocardiography.

Recurrent idiopathic pericardial effusion can be a challenging medical problem. Multiple medical interventions may yield minimal improvement. We describe a patient with an incessant pericardial effusion that responded to infliximab. The use of infliximab should be considered in the management of recurrent pericardial effusions resistant to other treatment modalities.