Pulmonary valve or main pulmonary artery infective endocarditis is rare in children and is associated with high morbidity and mortality. Fungal infective endocarditis, most commonly caused by Candida species, is particularly aggressive and often requires a combination of antifungal therapy and surgical intervention. We report two infants who developed Candida endocarditis following pulmonary artery banding.

In the first case, a female infant developed persistent candidemia after pulmonary artery banding, with echocardiography revealing a mobile mass at the pulmonary bifurcation and computed tomography angiography demonstrating a mycotic pseudoaneurysm. Blood cultures confirmed Candida albicans. She underwent debanding and main pulmonary artery reconstruction, later requiring pacemaker implantation, and recovered without relapse. In the second case, a female infant presented with fever and candidaemia after pulmonary artery banding. Echocardiography identified a distal main pulmonary artery vegetation, and cultures grew Candida parapsilosis. She received amphotericin B–based induction therapy followed by fluconazole step-down after surgical source control, achieving clinical cure at follow-up.

These cases highlight the diagnostic and therapeutic challenges of Candida endocarditis after right-sided palliation. Early multimodality imaging, species-directed antifungal therapy, and timely surgery are critical to optimise outcomes in this rare but life-threatening complication.

We report a rare case of a 3-month-old male infant with Down syndrome, severe pulmonary arterial hypertension (a large patent ductus arteriosus, an atrial septal defect, and a giant hepatic arteriovenous malformation). Initial treatment involved hepatic arteriovenous malformation embolisation using 17 Azur® CX Peripheral Coils, resulting in clinical improvement. However, persistent pulmonary arterial hypertension led to patent ductus arteriosus closure using an 8-mm Lifetech Cera™ vascular plug after a successful balloon occlusion test. Post-intervention, the patient showed symptomatic relief, reduced right ventricular overload, and atrial septal defect shunting shifted to left to right. This is the first reported paediatric case combining these features successfully managed through a multidisciplinary and stepwise treatment approach, eliminating the need for liver transplantation.

In isolated subclavian artery, abnormal aortic arch development causes a loss of continuity with the aorta. Patent ductus arteriosus is a known cause of congestive heart failure. Herein, we present a rare case of congestive heart failure caused by isolated right subclavian artery and right patent ductus arteriosus associated with left-sided aortic arch treated by early closure.

A 50-year-old man presented with shortness of breath. The patient underwent ventricular septation for a single ventricle with L-malposition of the great arteries at 6 years of age. Examinations revealed that the calcified patch for septation was torn and perforated, resulting in a left-to-right shunt. We report a rare case of a single ventricle who survived after septation 40 years ago and underwent the reoperation due to a torn calcified patch.

A large left coronary artery fistula in a child was successfully closed percutaneously using an Amplatzer Vascular Plug II through an arteriovenous loop.

Total anomalous pulmonary venous drainage associated with hypoplastic aortic arch represents an exceptionally rare and intricate congenital cardiac anomaly. We report the case of a 13-day-old late preterm neonate presenting with infracardiac total anomalous pulmonary venous drainage, severe pulmonary hypertension, and a hypoplastic aortic arch. The patient underwent single-stage surgical correction involving rerouting of the pulmonary venous confluence to the left atrium and aortic arch reconstruction using autologous pericardial patch under cardiopulmonary bypass with selective cerebral perfusion. Postoperative recovery was favourable, marked by successful extubation, resolution of pulmonary hypertension, and absence of residual anatomical obstruction. This case highlights the feasibility and effectiveness of early, comprehensive surgical repair and the necessity of coordinated multidisciplinary perioperative care. Long-term follow-up remains vital for monitoring functional outcomes and detecting late complications.

We present an extremely rare case of anomalous single coronary artery from the pulmonary artery in a 2-month-old infant with severe heart failure. Due to the unique coronary anatomy, a modified venous arterial extracorporeal membrane oxygenation technique was employed to maintain coronary perfusion and prevent coronary steal. Following surgical reimplantation, the patient showed significant recovery and remains stable at 2-year follow-up.

Pulmonary veno-occlusive disease has no definitive cure apart from lung transplant. The reverse Potts shunt can be a palliative bridge to transplant. A post-arrest 14-year-old with severe pulmonary veno-occlusive disease on extracorporeal membrane oxygenation support was decannulated after reverse Potts shunt and survived to lung transplant. Reverse Potts shunt should be considered as a rescue in select patients with end-stage pulmonary veno-occlusive disease.

Both mitral annular disjunction and coronary artery anomalies are associated with ventricular arrhythmia, though data on their co-occurrence are limited. We herein present two patients with anomalous aortic origin of a coronary artery and mitral annular disjunction who had ventricular arrhythmia. Mitral annular disjunction should be considered as a potential cause of ventricular arrhythmia when stress tests rule out ischaemia.

Ductus arteriosus aneurysm typically resolves spontaneously; surgical resection is required when it compresses surrounding structures and causes symptoms. In our neonatal case, the ductus arteriosus gradually regressed, but the left pulmonary artery stenosis persisted; therefore, balloon dilation was performed to address the ongoing imbalance in bilateral pulmonary perfusion. This case underscores the potential for non-surgical management of ductus arteriosus aneurysms.

Interruption of the aortic arch is a rare congenital cardiac malformation with rare cases described in adulthood. Survival in adulthood relies on developing collateral networks to maintain distal flow. CHD occurs in almost 50% of Turner syndrome and is the most frequent cause of early mortality. Also, they have an increased risk factor for thoracic aortic dilatation, and elective surgery should be considered according to body surface area. Surgical correction is the preferred treatment for the interrupted aortic arch and aortic root dilatation. We present the case of a 46-year-old patient with Turner syndrome with a diagnosis of interrupted aortic arch and aortic root aneurysm who underwent the Bentall procedure and interposition of a Dacron graft in the descending aorta. Post-procedural recovery was uneventful with a good haemodynamic response.

Severe dilated cardiomyopathy in children may uncommonly be caused by abnormal loading conditions such as mid-aortic pathology and renal artery stenosis. Refractory hypertension and left ventricular dilatation with hypertrophy are important clues to reversible causes. We present a case of dilated cardiomyopathy in a child secondary to mid-aortic syndrome with renal artery stenosis.

Interruption of the inferior caval vein complicates device closure of atrial septal defects. We present a case where a simplified technique was used: from right jugular access the delivery system was directly engaged into the left atrium, where the entire septal occluder was deployed. Both discs were aligned with the interatrial septum, after which the right disc was recaptured and re-deployed in the right atrium under tension. This technique will allow device closure of atrial septal defects from the upper caval vein in selected cases.

We evaluated quality characteristics of cardiac point-of-care ultrasound performed in our paediatric cardiac ICU. Of 47 included patients, diagnostic imaging was feasible in a high percentage of patients with good image quality. Intensivist interpretations of images were highly specific for dichotomised abnormal findings when compared to interpretation from a cardiologist with expertise in imaging but challenges in accurately assessing depressed ventricular function and the risk of discrepant interpretations exist even amongst frequent users with extensive training and experience. These findings may serve as a template for continued development of cardiac point-of-care ultrasound in a high-impact clinical environment.

Protein-losing enteropathy remains a formidable and underrecognised complication following Fontan surgery, contributing significantly to morbidity and mortality among affected patients. Despite substantial progress in managing single-ventricle CHDs, protein-losing enteropathy persists as a major clinical challenge, particularly in resource-constrained environments where specialised diagnostic modalities are scarce. This manuscript discusses the prevalence, clinical presentation, diagnostic hurdles, and management of protein-losing enteropathy in post-Fontan patients, drawing from clinical experiences in Vietnam. Among 95 post-Fontan patients reviewed, the prevalence of protein-losing enteropathy was 4.2%, with considerable morbidity necessitating invasive interventions and, in some cases, resulting in mortality. Diagnostic limitations, including restricted access to alpha-1-antitrypsin clearance testing, highlight the urgent need for heightened clinical suspicion and pragmatic diagnostic approaches. We advocate for integrating low-cost, widely accessible screening measures, such as routine serum protein monitoring, into standard post-Fontan care protocols to enhance early detection and management of protein-losing enteropathy. Furthermore, we underscore the critical importance of global collaboration and multicentre research initiatives to address the worldwide burden of protein-losing enteropathy, facilitate resource-sharing, and develop evidence-based interventions. Coordinated international efforts are essential to closing diagnostic and treatment gaps, ultimately improving survival and quality of life for patients living with the Fontan circulation.

Neonatal truncal valve insufficiency carries high postoperative mortality. Mechanical replacement is challenging, and leaflet-sparing repair alone may be insufficient due to fragile tissue and annular dilatation. We report a successful case using geometry-based root reconstruction guided by body-weight–adjusted reference values. This native-tissue approach restored physiologic root geometry, preserved the valve, and enabled growth potential, demonstrating a feasible strategy for durable neonatal repair.

Balloon-expandable MyVal OCTACOR valves were evaluated in 3D-printed conduits under simulated flow. The 20 mm valve functioned from 16–24 mm, rupturing at 27 mm. The 29 mm expanded to 33 mm with mild insufficiency. Findings suggest OCTACOR valves may support repeated valve-in-valve procedures, with the 20 mm showing greater versatility for small-infant mitral replacements and as a potential alternative to Melody valves.