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BACKGROUND: Atrial septal defects (ASDs) are one of the most common congenital cardiac abnormalities. Repair of these defects is a quite secure and routine operation. The most common complications were postoperative atrial arrhythmias, sinus arrhythmia, and atrioventricular (AV) blocks requiring pacemaker implantation, mediastinal bleeding, and transient ischemic attacks (TIAs) or strokes. Iatrogenic diversion of the inferior vena cava (IVC) to the left atrium (LA) during surgical closure of an ASD is a very rare complication. CASE REPORT: We reported a patient who had a history of cardiac surgery in another center at the age of seven and was introduced to our clinic with complaints of dyspnea and cyanosis of extremities on exertion. She underwent surgery in our center with diagnosis of iatrogenic diversion of IVC to LA. CONCLUSION: The most common mechanism suggested is a large eustachian valve being mistaken for the inferior rim of the ASD. [ABSTRACT FROM AUTHOR]

Introduction: Balloon angioplasty has been successfully used to dilate vascular obstructions. However, its value in some conditions such as supravalvular pulmonary stenosis is still controversial. Although some surgical techniques have been reported to achieve acceptable short- and long-term successes, they are invasive and technically challenging and may result in higher morbidity and mortality compared to percutaneous procedures. Case Presentation: Successful balloon dilatation was reported for two patients with supravalvular stenosis. One of them had supravalvular pulmonary stenosis developed after pulmonary artery debanding and the second one had supravalvular pulmonary stenosis due to an obstructive congenital web at that site. Conclusions: The use of balloon dilatation to treat supravalvular pulmonary stenosis is still controversial. However, experiences in two patients showed successful results. [ABSTRACT FROM AUTHOR]

Introduction: Treatment of patients with concomitant Patent Foramen Ovale (PFO), Atrial Septal Aneurysm (ASA), and multi fenestrated Atrial Septal Defects (mfASDs) is accompanied by many challenges. There may be even a need for different devices in the atrial septum, which is more challenging and costly. Case Presentation: This study aimed to report a case of PFO closure, which turned out to have ASAs and multiple small holes. A Uni occlutech device was used to close the PFO and fenestrations, which was done successfully and without complications. Conclusions: It is important to have a thorough evaluation of the atrial septum to rule in or out the possibility of multiple defects. This is done by accurate interrogation of the atrial septum by color Doppler echocardiography, preferably by transesophageal or three-dimensional echocardiography at the time of catheterization. Multiple small defects or fenestrations nearby may be closed by a single device, which may cover several defects or fenestrations. [ABSTRACT FROM AUTHOR]

Introduction: Paravalvular leak after prosthetic valve operation affects up to 27% of all prosthetic heart valves implanted by conventional surgery, which can be the cause of serious complications like hemolysis and congestive heart failure. Surgical reintervention is the conventional treatment of choice for severe cases, but it is associated with significant morbidity and mortality and is not always successful because of underlying tissue fragility. Over the last decade, transcatheter treatment of paravalvular leaks has emerged as an attractive alternative to surgery for high-risk patients and is now favored as the initial approach in some experienced centers. Significant paravalvular leaks are not common following a pulmonary valve replacement and may be more complex anatomically than left-sided paravalvular leak due to the variability in implant location and technique in the trabeculated and often dilated and fibrotic right ventricular outflow tract. Case Presentation: This study aimed to report two patients with successful transcatheter closure of a complex paravalvular leak utilizing Ventricular Septal Defect (VSD) and Patent Ductus Arteriosus (PDA) occluder devices following mechanical and bioprosthetic Pulmonary Valve Replacement (PVR). The cases included a 34-year-old and a 26-year-old man who were known cases of tetralogy of Fallot with a history of total correction operation (TFTC). Conclusions: The results showed that paravalvular leak could be a hemodynamically serious complication of surgical PVR and that transcatheter device closure was an acceptable way for the relief of these defects. However, the best approach for the closure of pulmonary paravalvular leak depends on specific anatomic structures and the origin or course of the coronary arteries that must be evaluated before device implantation. [ABSTRACT FROM AUTHOR]

Idiopathic right atrial dilation is known as a congenital anomaly in the absence of obvious causes that produce right ventricular pressure or volume overload. Congenital giant right atrium can cause functional tricuspid regurgitation, arrhythmia, and right-sided heart failure. A massive Idiopathic Dilation of Right Atrium (IDRA) was reported in a 30-year-old man presented with intermittent palpitation and dyspnea on effort. Transthoracic echocardiography revealed huge right atrium leading to severe tricuspid regurgitation, moderate right ventricular enlargement with moderate dysfunction, and no evidence of other valvular heart diseases increasing the right ventricular pressure or volume, left to right shunt, and Ebstein anomaly. Cardiac Magnetic Resonance Imaging (MRI) confirmed the right atrial enlargement. The estimated right atrium volume by MRI was about 700 mL. With regard to the patient's symptoms, he was scheduled for surgical treatment. The patient underwent partial surgical resection of the dilated right atrium wall and mechanical tricuspid valve replacement because the tricuspid valve was unrepairable on the operation table. Idiopathic right atrial enlargement is a very rare disease and may be easily confused with other anomalies that lead to right atrial enlargement, such as Ebstein anomaly. Hence, the probability of this pathology should be kept in mind when the usual etiologies of right atrial enlargement are excluded. Partial surgical resection of the dilated right atrium is an effective therapeutic option in symptomatic patients. [ABSTRACT FROM AUTHOR]