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A 12-year-old male patient with complete heart block was diagnosed by cardiac catheterization to have an unruptured aneurysm of the sinus of Valsalva eroding into the interventricular septum. Aortic regurgitation was absent and he underwent permanent pacemaker implantation. Three years later, he was readmitted with severe aortic regurgitation and left ventricular failure. The pacemaker was replaced and the patient underwent successful patch closure of the aneurysm and aortic valve replacement. The mode of presentation, noninvasive methods of evaluation, and surgical management of this rare cardiac pathology are discussed.

We report an unusual case of ventricular septal defect following triple valve replacement. The defect was detected at follow-up 3 months after surgery. The site of the defect was subaortic and restrictive in nature. As it did not lead to hemodynamic deterioration, the patient was treated conservatively and she has remained asymptomatic.

A 39-year-old male underwent an attempted right internal jugular vein cannulation during which the right common carotid artery was punctured. Three months later, the patient presented with dysphagia and breathlessness. Carotid angiography failed to demonstrate the pseudoaneurysm because of intra-aneurysmal clots but it was partially delinated by a direct puncture arteriogram of the swelling. At surgery a pseudoaneurysm measuring 8 × 6 cm was excised and the carotid artery was repaired with a saphenous vein patch.