Burkholderia cepacia is a rare cause of prosthetic valve endocarditis. We report an 18-year-old male with Tetralogy of Fallot and two sequential transcatheter pulmonary valves (Melody and Myval), presenting with persistent bacteraemia unresponsive to antibiotics. Surgical explantation of both valves with homograft replacement and tricuspid repair achieved complete recovery, emphasising surgery in refractory infections.

A four-month-old infant with severe congenital aortic stenosis underwent successful percutaneous transcatheter balloon valvuloplasty. While initially stable, ventricular bigeminy was detected at six-week follow-up, likely due to post-procedural myocardial inflammation. The arrhythmia resolved spontaneously by 12 weeks. This case highlights the need for vigilant post-percutaneous transcatheter balloon valvuloplasty monitoring to detect and manage late-onset arrhythmic complications.

Sudden cardiac death poses a significant risk in patients with surgically repaired tetralogy of Fallot. Despite extensive research, risk stratification practices vary. This study surveyed the Pediatric and Adult Congenital Electrophysiology Society to identify these differences. Results showed diverse practices in indications, methods, and interpretation of electrophysiology studies, highlighting a need for standardised algorithms to improve patient outcomes.

Transcatheter pulmonary valve replacement (TPVR) is often employed for patients who are poor surgical candidates. We present a case of posterior sternal protrusion into a surgically placed right ventricle to pulmonary artery conduit, making the patient a poor candidate for surgical replacement and leading to significant operator distress during ultimately successful TPVR.

Coronary artery fistulas are rare cardiac anomalies, often asymptomatic and frequently discovered incidentally during routine cardiac imaging. Transcatheter closure with coil embolisation is increasingly recognised as a preferable alternative to surgical intervention due to its lower complication rates. In this report, we present three paediatric cases in which coronary artery fistulas were successfully embolised using the Azur® CX Peripheral Coil System. This system demonstrates low-profile suitability for occluding highly tortuous vessels in children, enabling controlled coil delivery via a microcatheter. Its hydrogel-coated coils allow for expansion between gaps, making it highly effective as a minimally invasive treatment.

Hybrid procedure of hypoplastic left heart syndrome, comprising ductus arteriosus stenting and bilateral pulmonary artery banding, is a good surgical option for initial palliative procedure for high-risk patients for Norwood procedure. However, ductal stenting may cause retrograde aortic blood flow obstruction. Furthermore, complete removal of stent while performing the Norwood procedure make the operation more difficult. We report a case that overcame these problems using a novel surgical technique.

An adolescent girl with a long-standing history of pulmonary arterial hypertension experienced severe clinical decompensation after starting to use e-cigarettes. A combination of e-cigarette cessation, atrial septostomy, increasing treprostinil, and initiation of sotatercept led to clinical improvement. Her new baseline was improved over her pre-e-cigarette baseline.

Hepatopulmonary fusion is a rare defect describing the physical connection of liver and lung. A neonate with hypoplastic left heart syndrome arrived at the hospital with concern for congenital diaphragmatic hernia, later found to have hepatopulmonary fusion. In the coming months, he underwent a series of operations, including ligation of the hepatopulmonary fusion and the first two stages of surgical palliation of hypoplastic left heart syndrome. He ultimately died of septic shock at 15 months of age.

Ventricular assist devices, such as the HeartMate 3, are routinely used to support patents with failing ventricular function. However, extrinsic obstruction of the outflow graft has been identified as a complication associated with the HeartMate 3. We report a case of a patient with transposition of the great arteries (d-TGA), status post-Mustard procedure with severe systemic (right) ventricular dysfunction who developed extrinsic obstruction of theoutflow graft, 6 years after implant, leading to a significant reduction in HeartMate 3 flow. This patient required the placement of multiple stents to fully address the diffuse stenosis of the outflow graft. This case underscores the technical challenges involved in managing extrinsic obstruction of theoutflow graft in patients with this anatomy and highlights the importance of a tailored, multidisciplinary approach. It emphasises the need for careful planning around stent overlap, outflow graft angulation, and catheter and wire positioning in the context of complex anatomical and device-related interactions.

Pulmonary vasodilators increased the systemic-to-pulmonary collateral flow in two single-ventricle cases, causing haemodynamic decline. Discontinuation reversed the collateral flow and improved heart failure, highlighting the need for careful monitoring. Serial cardiac MRI, as a non-invasive tool, may be essential to detect changes in collateral flow and guide vasodilator use for optimal management in this population.

We describe a 12-year-old boy with agenesis of the intrahepatic segment of the inferior vena cava (a rare congenital anomaly) in whom an electrified coronary guidewire with electrocautery was used percutaneously to perforate and open the atretic segment, followed by stent implantation. This technique may be a safe and feasible option for paediatric patients, offering a therapeutic alternative for complex cardiac anatomies.

We report the first documented case of isolated double-orifice mitral valve causing significant left ventricular outflow tract obstruction in an infant. Echocardiography revealed a complete bridge-type double-orifice mitral valve with aberrant chordal insertion into the interventricular septum, producing severe left ventricular outflow tract obstruction. This rare presentation underscores the importance of meticulous echocardiographic assessment for accurate diagnosis and surgical planning.

We report a rare case of coronary sinus ostium atresia diagnosed due to impaired cardiac function caused by Marshall vein stenosis, which occurred during surgical treatment. Transcatheter perforation of the coronary sinus ostium and stenting of the Marshall vein stenosis improved ventricular function, enabling subsequent surgical enlargement. This staged strategy minimised surgical risks and demonstrated a reliable and effective treatment for such challenging conditions.

Mitochondrial trifunctional protein deficiency is a long-chain fatty acid disorder that may include manifestations of severe cardiomyopathy and arrhythmias. The pathophysiology for the severe presentation is unclear but is an indicator for worse outcomes. Triheptanoin, a synthetic medium chain triglyceride, has been reported to reverse cardiomyopathy in some individuals, but there is limited literature in severe cases. We describe a neonatal onset of severe disease whose clinical course was not improved despite mechanical support and triheptanoin.

This article presents the case of a 3-year-old boy whose primary symptom was hypoproteinemia. After evaluations at multiple hospitals, he was sequentially diagnosed with protein-losing enteropathy and constrictive pericarditis. Following pericardiectomy, his albumin levels returned to normal. Additionally, a review of several similar cases is provided, with the aim of aiding in the diagnosis of related conditions.

We report the first case in Vietnam of transcatheter pulmonary valve-in-valve implantation using the self-expanding Pulsta valve in a young adult with repaired Tetralogy of Fallot. This case demonstrates the feasibility, safety, and early effectiveness of self-expanding valves in complex right ventricular outflow tract anatomies and highlights the importance of multimodal imaging in procedural planning.

Heart failure in children is a clinical and pathophysiological syndrome arising from ventricular dysfunction and pressure or volume overload of the circulatory system. Features of paediatric heart failure include feeding problems, poor weight gain, exercise intolerance, or dyspnoea. The aetiology of heart failure in children is complex, with the primary causes being CHD and cardiomyopathies. Cardiomyopathies occur at an incidence of 1.13–1.24 cases per 100,000 children. The prevalence of cardiomyopathy is estimated to be 7.8–8.3 cases per 100,000 infants, particularly common in patients under one year of age presenting with severe heart failure symptoms. Mitral valve insufficiency is a significant source of morbidity in children with dilated cardiomyopathy. Severe mitral insufficiency can lead to a decrease in cardiac output, independent of the left ventricular ejection fraction, exacerbating the clinical course of heart failure in patients with dilated cardiomyopathy. As ventricular systolic function deteriorates, the options for treating mitral insufficiency decrease, leading to a loss of surgical intervention opportunities and making heart transplantation the only viable option. Close monitoring of mitral valve insufficiency in children with dilated cardiomyopathy is essential, as it may lead to decompensated heart failure. In patients who have lost the chance for valve surgery due to decompensation, the application of left ventricular assist device can help improve the decompensatory state and contribute to the reduction of left ventricular diastolic and systolic dimensions, consequently leading to improvements in the dilation of the mitral annulus and severe mitral insufficiency findings. Further studies are needed to determine the optimal timing for surgery in patients who have not missed the chance for valve surgery due to a decrease in ejection fraction.

Pericardial cysts are rare, benign congenital cardiovascular malformations that account for approximately 7% of mediastinal masses. Epicardial cysts attached to the cardiac surface with intimate coronary artery involvement are even rarer and pose significant diagnostic and surgical challenges. This case highlights a giant pericardial cyst with intimate right coronary artery involvement in a 10-month-old infant, where subtotal resection was necessary to preserve coronary integrity. A 10-month-old male infant with a pericardial cyst initially detected at 27 weeks of gestation presented with progressive compression of right heart chambers. Imaging revealed a large multiloculated cystic mass (5.3 × 3.5 × 3.9 cm) compressing the right atrium and right ventricle, with associated pulmonary valve stenosis. Intraoperatively, the cyst was found on the epicardial surface with intimate involvement of the right coronary artery. Complete excision was not feasible due to the risk of coronary injury. The main cystic mass was excised with cavity obliteration, while the portion adjacent to the right coronary artery was intentionally preserved. Concurrent pulmonary valve commissurotomy and pulmonary artery augmentation were performed. Histopathology confirmed a mesothelial-lined pericardial cyst. The patient recovered uneventfully and was discharged. This case underscores the importance of comprehensive preoperative coronary artery assessment in pericardial cysts with atypical locations. When complete excision risks vital structure injury, subtotal resection with cavity obliteration represents a safe alternative strategy.