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: The usual surgical practice after repair of a Total Anomalous Pulmonary Venous Connection (TAPVC) is to ligate the vertical vein (VV). Many surgeons find it expedient to leave the VV unligated to reduce pulmonary arterial pressure, decrease perioperative pulmonary hypertensive crisis, provide better hemodynamics postoperatively (1), and enable the adaptation of cardiac chambers to a new workload. Afterwards, the unligated VV may cause significant left-to-right shunt, likewise an atrial septal defect, mandating later surgical ligation or device closure (2). This report details transcatheter occlusion of a patent VV using a device Amplatzer Vascular Plug II, after TAPVC repair in early infancy. The transcatheter occlusion of an unligated VV after repair of supracardiac TAPVC represents an effective alternative to surgical redo. The device Amplatzer Vascular Plug II achieves great results.

We report the case of a 14-year-old boy affected by Tetralogy of Fallot and pulmonary atresia, who had already undergone multiple surgical procedures. He had later developed a steno-insufficiency of the pulmonary bioprosthesis. We performed a percutaneous pulmonary valve implantation (PPVI), which is a minimally invasive treatment, as effective as conventional valve surgery and associated with less morbidity and mortality. Up to now PPVI has been carried out in patients with chronic pulmonary vascular resistance (PVR) in the presence of a right ventricular outflow tract (RVOT) patch by prior deployment of an intravascular stent as an artificial conduit that makes subsequent valve implantation possible. The peculiarity of our procedure was that we implanted the valve directly on to the annulus of the bioprosthesis (valve-in-valve), without performing a prestenting of the prosthetic valve.