A 55-year-old male with persisting aorto-right ventricular paraprosthetic leak after mitroaortic valve replacement was hospitalized for recurrent heart failure. Depressed left ventricular ejection fraction and severe pulmonary hypertension with increased right and left ventricular filling pressures were associated with significant left to right shunting through the leak. Elective closure of the leak was obtained with a 6-4 mm Amplatzer duct occluder. No complications were observed, and the patient experienced complete resolution of heart failure symptoms, with NYHA class I heart failure 12 months after discharge.

Balloon pulmonary valvoplasty was performed in a patient with congenitally corrected transposition, aged 28 years, who had already undergone surgical closure of a ventricular septal defect and implantation of a conduit between the pulmonary arteries and the right-sided morphologically left ventricle. The patient developed stenosis of the conduit 22 years after the procedure as confirmed by cardiac catheterization and angiocardiography, which also showed stenosis of the native pulmonary valve. A balloon valvoplasty of the native valve was carried out with improvement of the gradient from the ventricle to the pulmonary arteries. The patient developed complete heart block immediately after the procedure, which reverted to first degree block in one week and to the previous cardiac rhythm within 21 days.