Objectives: Ventricular septal defect (VSD) is the most common congenital heart disease (CHD) (40%). Traditionally, VSDs have been repaired surgically; however, recently VSD closure by device has been developed. This study aimed to compare these two methods in terms of effectiveness, outcomes, and complications. Materials and Methods: This study was conducted on VSD patients who were treated by either surgery or trans catheter technique in Madani Heart Center from March 2011 to March 2017. The required data regarding effectiveness, outcomes, and complications were recorded based on the patient’s documents. The extracted data were analyzed by SPSS version 18.0. Results: A total of 93 patients were enrolled (43 patients in transcatheter [A] and 50 patients in open-heart surgery [B] group) in this study. The gender distribution was approximately the same. The mean age of group A was 10.55 years while it was 8.8 years for group B. The duration of ICU and hospital stay, total hospitalization cost, and frequency of blood products transfusion were significantly lower in group A than in group B. However, postoperative pacemaker insertion, arrhythmias, thromboembolism, and mortality rates did not show any significant difference between the two groups. The success rates in group A and B were 97.7% and 96%, respectively. Conclusions: The results of our study demonstrated that open-heart surgery, due to its nature, required longer hospital and ICU stay, higher cost, and higher blood transfusion rate than transcatheter therapy, but it was associated with similar complications and success rates. Therefore, device closure in appropriately selected patients is recommended as an alternative to the surgical approach.

Introduction: Overally the anomaly of the coronary arteries are rare. Its incidence according to angiographic, autopsy and echocardiographic findings, are about 1%, 0.29% and less than 0.1% respectively. Usually these are the incidental finding during angiography without clinical presentation. These anomalies may be accompanied by myocardial ischemia, arrhythmia, syncope and sudden death. Case Presentation: We present a 14-year-old Iranian boy who experienced chest pain and shortness of breath after engaging in physical activity. The right coronary artery (RCA) had an intramural and inter-arterial course and was proven to have originated from the left sinus of Valsalva by computed tomographic coronary angiography (CTCA). The RCA began adjunct to the ostium of the left main coronary artery and coursed intramural at first and then continued between the aorta and pulmonary artery. The patient underwent corrective surgery. The RCA was cut from origin and reanastomosd to the right coronary sinus after preparing the sinus. The patient recovered well and he was discharged with the ability to perform sports activity. One year Follow up of the patient was uneventful. Conclusions: Even though single ostium coronary artery abnormalities are uncommon, they have become more frequently identified in recent years using non-invasive techniques such transthoracic echocardiography, which is then followed by CT angiography or conventional angiography. These patients are susceptible to sudden death, so attention to symptoms of the patients and comprehensive approach to them can be lifesaving.