Transoesophageal and epicardial echocardiography are indispensible intraoperative imaging modalities to guide paediatric heart disease surgeries and influence surgical decision-making. A less well-described role of intraoperative imaging is its utility in evaluating coronary artery patency and flow. Focused two-dimensional, colour, and spectral Doppler imaging of the coronary arteries should be performed during surgeries involving coronary manipulation or re-implantation, or in cases where there is unexpected ventricular dysfunction or electrographic signs concerning for ischaemia. Intraoperative imaging allows for any anatomical issues to be detected and addressed promptly in the operating room. Imaging of the coronary arteries should identify unobstructed coronary ostia and proximal course without kinking, angulation, narrowing, or significant calibre change to suggest stenosis or extrinsic compression from neighbouring structures. The aim of this review is to highlight the usefulness of transoesophageal and epicardial echocardiography in evaluating coronary artery patency and flow, provide a how-to guide for optimal imaging, and to introduce a practical guideline to achieve best clinical practice.

Transvenous pacemaker implantation for sinus node dysfunction in patients with Fontan palliation presents the difficulty of finding suitable pacing tissue and the potential of causing vascular obstruction in a low-flow circuit. We describe a patient who underwent electro-anatomic voltage mapping to guide a transvenous single chamber lead within her Fontan baffle. This highlights the use of advanced mapping technologies for pacemaker implantation in complex cyanotic heart disease.

The few data collections that evaluate the involvement of organ systems in horse diseases are in agreement that the locomotor, gastrointestinal and nervous systems are the sites of primary disease in the vast majority of sick horses. When compared with diseases of these organ systems, equine cardiovascular diseases occur infrequently. The most detailed and comprehensive survey of equine cardiac pathology was reported in 1972 by Else and Holmes, who summarized the gross and microscopic cardiac findings from 1500 abattoir horses. This paper reviews the pathology of the cardiovascular diseases typically encountered in horses. Most of the pathological examples are from the files of the Veterinary Medical Teaching Hospital at the University of Florida, encompassing 24 years (1978–2002) and some 6000 equine necropsy cases. Preceding the specific topics are principles of the anatomy and function of the normal equine heart. Pathological entities include equine congenital cardiovascular diseases, acquired diseases of the pericardium, myocardium, endocardium and valves, cardiac neoplasms, and common equine vascular diseases and vascular neoplasms. Extensive use is made of photographs to illustrate the features of individual case examples.