True congenital atresia of the left main coronary ostium: delayed presentation.

Congenital atresia of the left main coronary ostium is a rare coronary anomaly presenting in adulthood. A 48-year-old man presented with unstable angina. Coronary angiography showed an absent left coronary ostium with a super-dominant right coronary artery retrogradely filling the left system.

Flap valved closure of ventricular septal defects with increased pulmonary vascular resistance.

Closure of ventricular septal defect (VSD) in children with elevated pulmonary vascular resistance (PVR) is associated with significant morbidity and mortality with pulmonary hypertensive (PH) episodes being a major postoperative problem. Flap valved closure of VSD is reported to decrease morbidity and mortality. We report our experience of closure of a VSDs in patients with severe PH, using a valved patch in an effort to reduce the risk of operation.