Isolated persistence of the fifth aortic arch in an infant presenting with congestive heart failure.

The persistence of the fifth aortic arch (PFAA) in postnatal life is an extremely rare and controversial cardiovascular malformation. PFAA is defined as an extra-pericardial vessel arising from the ascending aorta proximal to the origin of the brachiocephalic arteries, terminating either in the dorsal aorta or in the pulmonary arteries through the persistently patent arterial duct. An isolated PFAA with systemic-to-pulmonary connection best fits this definition, while the vast majority of cases reported as PFAA may have alternative embryological explanations.

Balloon angioplasty of aortic coarctation in critically ill newborns using axillary artery access.

Balloon angioplasty may be performed as the first treatment of aortic coarctation to stabilize newborns too sick for immediate surgery. The issue of vascular access is the key to the successful treatment of critical newborns. In our study, we argue that the lesser-known axillary access route is the safest and most effective route of vascular access for balloon angioplasty in infants with aortic coarctation.

Feasibility and safety of a new generation of gore septal occluder device in children.

Aim: Transcatheter closure of an ostium secundum atrial septal defect (ASD) is now considered the standard care for most of children with the appropriate anatomy, and is a relatively well-tolerated procedure to reduce the clinical sequelae of ASD, with a low complication rate.

Methods: The present case reports describe our clinical experience of the percutaneous closure of a secundum ASD in 10 children between December 2011 and November 2012, by means of a new generation of device, the GORE Septal Occluder device.

Results: The implantation was successful in all except two cases, the device being properly placed and deployed without malposition or embolization in the catheterization laboratory.

Percutaneous implantation of Edwards SAPIEN valve into pulmonary bioprosthesis (valve-in-valve).

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.

Double aneurysm of the left ventricular wall following cardiac perforation after aortic valvuloplasty.

In this report we present the case of a double aneurysm, which developed 1 week after pericardiocentesis because of cardiac perforation following aortic valvuloplasty in a newborn. The patient underwent successful surgical treatment through normothermic cardiopulmonary bypass with external plication of double aneurysm.