Aortico-left ventricular tunnel is a rare congenital heart defect. Reports on successful device closure of these defects are scarce. We are reporting the first case of device closure of aortico-left ventricular tunnel using an Amplatzer vascular plug III.

In neonates with coarctation of the aorta, left ventricular function may be impaired due to an increased afterload and an associated endocardial fibroelastosis. Repair of the coarctation usually results in improvement in left ventricular function over the postoperative weeks. We report a patient in whom, despite successful repair of coarctation, left ventricular performance continued to deteriorate. Investigation revealed the unusual coincidental finding of anomalous left coronary artery from the right pulmonary artery.

A persistent omphalomesenteric vein (POMV) maintaining a link between the pulmonary venous system and the infracardiac hepatic venous system can lead to significant left-to-right shunting. To the best of the authors' knowledge, POMV causing significant left-to-right shunting has been unreported previously, especially in association with type B interrupted aortic arch. This report describes this association in a child who had chronic heart failure even after successful repair of interrupted aortic arch and ventricular septal defect. Subsequent percutaneous device closure of the POMV using an Amplatzer vascular plug II led to resolution of the child's heart failure.

Anomalous origin of Left Coronary Artery from Pulmonary Artery (ALCAPA) is a rare congenital malformation, which can result in myocardial infarction, congestive heart failure and sudden death if left untreated. Reports of myocardial revascularization and Mitral Valve (MV) repair following ALCAPA repair in infants are uncommon. We report a critically ill infant with ALCAPA needing myocardial revascularization and MV repair after which there was early recovery of Left Ventricular (LV) function. At two years follow up, the child is clinically well; the postoperative cardiac catheterization shows good flow in the Left Internal Mammary Artery (LIMA) and Left Anterior Descending artery (LAD), good LV function and competent mitral valve. (Ind J Thorac Cardiovasc Surg 2009; 25: 192-194)