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Atrial septal defect (ASD) is one of the most common congenital heart defects found in adults. Percutaneous device closure using the Amplatzer ASD occluder (AGA Medical Corp, Golden Valley, Minn) is widely used for the treatment of ASD and proven to be effective and safe as traditional surgical repair. However, procedure-or device-related complications can occur, which can be fatal. We report a rare case of subacute and silent embolization of an Amplatzer device to the pulmonary artery on the next day of successful percutaneous ASD closure.

The objective of this paper is to describe the novel four-patch technique [modified Brom's] for repair of supravalvular aortic stenosis (SVAS). After transection of the aortaat the sinotubular junction, three longitudinal incisions are made into thethree sinuses. The aortic root geometry was restored by placement ofthree separate patches of autologous pericardium in the opened sinuses. One additional diamond shaped pericardial patch placed anteriorly between proximal and distal aorta. This modified four patch technique provides a complete and symmetric restoration of theaortic anatomy with insignificant gradient and good short-term and potentially good long-term results.

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