A 58‐year‐old woman was referred to our hospital with progressively increasing breathlessness. She reported a history of bioprosthetic valve implantation for tricuspid valve replacement and direct closure of an atrial septal defect for Ebstein's anomaly, 31 years before presentation. Transthoracic echocardiography revealed prosthetic valve failure, an enlarged coronary sinus, and severe mitral regurgitation. Computed tomography revealed a giant coronary sinus with thrombosis and persistent left superior vena cava. She underwent successful mitral and tricuspid valve replacement; however, severe hemodynamic deterioration necessitated mechanical ventilatory support with extracorporeal membrane oxygenation.

Although radiation therapy is widely used to treat breast cancer, high doses of radiation may cause various complications. We report a case of a left ventricular aneurysm complicated with an intractable skin ulcer caused by radiation therapy for breast cancer. The communication between the aneurysm and skin ulcer caused severe bleeding. An urgent left ventricular repair and chest wall reconstruction with a rectus abdominis flap were performed successfully.

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We report a 65-year-old man who underwent aortic valve replacement because of severe aortic stenosis associated with de novo iatrogenic variant transthyretin amyloidosis derived from a liver graft extracted from a patient with hereditary transthyretin amyloidosis 9 years after the domino liver transplantation. ( Level of Difficulty: Advanced. )

A 34-year-old woman was referred to our hospital for inspection before operation for liver transplantation as a donor for her son. She had no symptoms and remarkable medical history. Echocardiography showed a defect in lower part of the atrial septum with a cleft of left atrioventricular valve and right atrioventricular valve regurgitation. She was diagnosed as incomplete atrioventricular septal defect for the first time. She underwent double valve repair and patch closure of the atrioventricular septal defect. It is a rare case for atrioventricular septal defect in adulthood incidentally detected without symptoms.