We report two instances of transient isolated right-sided myocardial hypertrophy in patients with an intact ventricular septum, normal thickness of the posterior wall of the left ventricle, and normal ventricular function, diagnosed by echocardiography on the third day of life. The two neonates, born at 36 and 38 weeks gestation respectively, had perinatal distress. Both were diagnosed as having isolated right ventricular hypertrophy with mild pulmonary hypertension, which disappeared in both cases within 8 weeks without any specific therapy. Though the cause of the ventricular hypertrophy remains unclear, we believe that it is the consequence of remodeling of pulmonary vasculature secondary to acute perinatal distress, resulting in persistent pulmonary hypertension and producing pressure overload on the right ventricle, and hence right ventricular hypertrophy. The finding of early and transient right ventricular hypertrophy, with normal left-sided structures and normal ventricular function, has thus far failed to gain attention in the paediatric cardiologic literature.

A 53-year-old man with tetralogy of Fallot had been palliated with two classic Blalock-Taussig shunts. Cardiac catheterization in our center revealed acquired atresia of the pulmonary valve. We perforated and dilated the valve as a palliative procedure with a new system using radiofrequency energy.

An 8-month-old boy presented with right hemiplegia of sudden onset after 20 days of Kawasaki disease, which was not initially treated by gamma globulin. Cranial X-ray computed tomography confirmed cerebral infarction as the cause of the right hemiplegia. In subsequent weeks, he developed multiple thromboses in coronary aneurysms. He successfully underwent intracoronary thrombolysis using tissue plasminogen activator without haemorrhagic complications. Cerebral infarction as a complication of Kawasaki disease is rare, and is a difficult clinical situation to manage.

Transcatheter techniques for occlusion of the persistently patent arterial duct using coils have become standard therapy at many centers for pediatric cardiology, and in selected patients have demonstrated comparable efficacy to surgical ligation. Surgical ligation may still be required in many cases, including premature infants or those born with low weight, those with ducts of large diameter, those with associated structural heart disease, and in circumstances of unsuccessful occlusion subsequent to attempted closure using coils. We report on the successful surgical ligation of an arterial duct of moderate size that exhibited residual patency despite two separate attempts at occlusion using coils.

We report the interventional procedures performed on a 12-year-old child with obstruction of the right ventricular outflow tract, pulmonary valvar insufficiency, pulmonary arterial stenosis, and an atrial septal defect. A staged repair of all anomalies was performed successfully using transcatheter techniques.

We treated seromas developing in two patients in relation to left-sided modified Blalock-Taussig shunts by reattaching the original graft to the descending aorta. We postulate that seromas may develop because of the large area of contact between the graft and blood. Shortening the length of the Gore-Tex graft may therefore be a feasible treatment.

We describe a patient with diffuse varices of the right pulmonary veins in association with patency of the arterial duct and an atrioventricular septal defect with separate right and left atrioventricular valvar orifices.

The postpericardiotomy syndrome occurs in up to one-third of children undergoing cardiac surgery. Its treatment includes anti-inflammatory agents, diuresis, and drainage of effusions. Administration of steroids can have a dramatic effect, but is limited by adverse effects. Usually the syndrome lasts weeks only, and persistence beyond six months is exceptional. We describe a rare case of chronic postpericardiotomy syndrome, with recurrent pericardial effusions and steroid dependency, that was treated successfully with a low weekly dose of methotrexate.

We report an infant with a large perimembranous ventricular septal defect, who had two separate orifices in the tricuspid valve, each supported by separate cordal apparatus, detected incidentally during surgery.

Abnormalities of chromosomes 11 and 22 are associated with congenital cardiac disease and/or various syndromes. We present a patient with partial trisomy for the long arms of chromosomes 11 and 22, the result of a maternal balanced reciprocal translocation between these two chromosomes. Our patient was dysmorphic and had coarctation of the aorta, an atrioventricular septal defect with common atrioventricular junction and exclusively atrial shunting, patency of the arterial duct, supracardiac totally anomalous pulmonary venous connection, a single kidney, and tracheobronchomalacia. This patient is unusual in having extensive left-sided cardiac involvement, a feature not usually found in this condition.

Pulmonary oedema complicating balloon dilation of the pulmonary valve is extremely rare. We describe two children who developed acute pulmonary oedema soon after successful dilation of the pulmonary valve. They were treated with diuretics, ionotropes, and ventilatory support. Despite the supportive therapy, the complication proved fatal in one.

We describe a neonate presenting with a cholestatic jaundice due to Alagille syndrome. On echocardiography as part of the diagnostic work-up, we noted a slight dilation of the normally functioning left ventricle at the initial examination in the third week of life. Over the next 2 weeks, serial echocardiograms showed slowly progressive dilation and dysfunction of the left ventricle, together with a persistent mild elevation of levels of cardiac Troponin-I in the serum. These findings, unrelated to the underlying Alagille syndrome, prompted cardiac catheterisation, which confirmed that the main stem of the left coronary artery was originating from the pulmonary trunk. Surgery was successfully performed still in the presymptomatic period. The association of Alagille syndrome with anomalous left coronary artery arising from the pulmonary trunk is most unusual. We emphasise the cardiac findings prior to detection of the anomalous origin of the coronary artery.

In neonates with severe aortic or pulmonary stenosis, the obstructed circulation is usually supported through patency of the arterial duct. We describe a neonate in whom an aortopulmonary window supported a critically obstructed pulmonary circulation.

Ischemia of the leg in a peripartum female is an uncommon condition. Paradoxical arterial embolisation, and arterial dissection, are rarely encountered but recognized causes of this clinical condition. Peripartum cardiomyopathy is a rare life-threatening cardiac condition that can foster intracardiac thrombosis and produce peripheral vascular complications through embolization. We present here the case of a young, healthy, postpartum female who developed acute ischemia of the left leg, and asymptomatic arterial insufficiency of the right lower leg, as the presenting symptoms of peripartum cardiomyopathy, highlighting the fact that ischemia threatening the loss of a limb can be the initial manifestation of peripartum cardiomyopathy.