Stent under expansion is one of the reasons compromising the outcomes of percutaneous coronary interventions. The most common cause of the stent under expansion is calcium deposited in the atherosclerotic plaque. Adequate plaque modification is the paramount before the placement of a stent, as the options to handle under expanded stent are limited and less effective. In this case report, we explore the usage of knuckle wire for the extrastent plaque modification, after being failed with routine methods of handling stent under expansion.

Interrupted aortic arch (IAA) is a rare condition that generally requires surgical correction in the newborn. We report a case of delayed presentation of type A interrupted aortic arch with ventricular septal defect in a 13-year-old female. Single-stage correction without circulatory arrest was accomplished via midline sternotomy approach. Tissue-to-tissue anastomosis was performed without the use of prosthetic material in order to optimize chances for future growth. This simplified technique avoids additional procedures, reduces ischemic time, and prevents problems related to circulatory arrest.