Serial foetal echocardiography showed the development of severe left ventricular systolic dysfunction and thrombosis in a previously healthy foetus. Normal cardiac findings in a mid-trimester foetus do not exclude subsequent dilated cardiomyopathy.

A 20-day-old girl was referred to our clinic for systolic murmur, cyanosis, and dyspnoea with feeding. Echocardiography revealed an atretic aortic valve. CT angiography scan revealed that the left common carotid artery originated from the distal main pulmonary artery. The plan was patent ductus artriosus stenting and bilateral pulmonary artery banding and then follow-up for any possible future intervention.

We describe the use of low-dose dual-source cardiac for the evaluation of a neonate with suspected total anomalous pulmonary venous connection. This novel technique obviates the need for sedation or breathholding. Radiation dose-reduction strategies result in sub-mSv-estimated effective doses, substantially lower than annual background radiation dose. Low-dose, high-pitch cardiac CT should be considered as an alternative to MRI or diagnostic cardiac catheterisation in neonates with complex CHD, requiring definitive anatomic evaluation.

Left anterior accessory pathways are considered to be rare findings. Catheter ablation of accessory pathways in this location remains a challenging target, and few reports about successful ablation of these accessory pathways are available. We describe our experience regarding a case of a manifest left anterior accessory pathway ablation using radiofrequency energy at the junction of the left coronary cusp with the non-coronary cusp.

Isolation of the left subclavian artery is a rare anomaly associated with acyanotic CHDs and right aortic arch. This condition can be asymptomatic or can present with neurological and left upper-limb ischaemic symptoms; it does not form a vascular ring. Treatment options include implantation of the subclavian artery to the aortic arch vessels and closure of the patent ductus arteriosus to prevent pulmonary run off. Here we describe a child who was incidentally detected to have this condition during evaluation of atrial septal defect for device closure.

Limb ischaemia is a rare but catastrophic complication related to cardiac catheterisation. We report an infant weighing 3 kg with unrepaired tricuspid atresia type 1b, small patent ductus arteriosus, and ventricular septal defect presenting with cardiogenic shock owing to progressively reduced pulmonary blood flow from closing ventricular septal defect and patent ductus arteriosus. An emergency palliative ductal stent was successfully placed with marked clinical improvement. However, acute limb ischaemia developed necessitating above-knee amputation, despite medical management and vascular surgery. The cause of limb loss in our patient was catheterisation-related vascular injury causing arterial dissection–arterial thrombosis in the presence of shock and coagulopathy. This report emphasises the complexity in managing limb ischaemia associated with coagulopathy and highlights the importance of early recognition of reduced pulmonary flow in a single ventricle patient. Timely elective placement of a surgical systemic to pulmonary shunt would prevent catastrophic clinical presentation of compromised pulmonary flow and avoid the need for an emergent life-saving intervention and its associated complications.

Drug rash with eosinophilia and systemic symptoms is a drug hypersensitivity reaction. Hepatitis and nephritis are the most common visceral manifestations. Myocarditis is important to recognise, given the high mortality rate. We describe a child with drug rash with eosinophilia and systemic symptoms and discuss the role of N-terminal pro-hormone of basic natriuretic peptide in early recognition of associated myocarditis.

Using phase-contrast MRI in a foetus with borderline left ventricular hypoplasia at 37 weeks’ gestation we showed an increase in pulmonary blood flow during maternal hyperoxygenation. The associated increase in venous return to the left atrium, however, resulted in reversal of the atrial shunt, with no improvement in left ventricular output. The child initially underwent single ventricle palliation with a neonatal hybrid procedure, but following postnatal growth of the left ventricle tolerated conversion to a biventricular circulation at 5 months of age. We conclude that when there is significant restriction of filling or outflow obstruction across the left heart, neither prenatal nor postnatal acute pulmonary vasodilation can augment left ventricular output enough to support a biventricular circulation. Chronic pulmonary vasodilation may stimulate the growth of the left-sided structures allowing biventricular repair, raising the intriguing question of whether chronic maternal oxygen therapy might obviate the need for neonatal single ventricle pallation in the setting of borderline left ventricular hypoplasia.

We present a rare case of scimitar syndrome in which the scimitar vessel, collecting all the right pulmonary veins, was stenotic at its junction, with the inferior caval vein and two anomalous vessels, connecting to the same venous collector, draining most of the flow to the left atrium.

We arbitrarily defined this rare anatomical variant as a congenitally palliated scimitar syndrome.

The Medtronic LINQ™ was inserted in an 11-month-old boy for close monitoring of rapid ventricular tachycardia. The device is much smaller than the conventional Medtronic loop recorder. The real advantage of the LINQ™ is that it automatically notifies Carelink if any ventricular tachycardia is seen, which is very advantageous for this particular type of patient. This device is ideal for close monitoring of asymptomatic yet potentially dangerous arrhythmias in smaller children.

A 31-year-old patient previously underwent a Mustard operation presented with palpitations. Atrial tachycardia and paroxysmal atrial fibrillation were documented on the surface electrocardiogram. Under the guidance of a three-dimensional electroanatomic mapping system, ablation of the isolated left-sided pulmonary vein and a cavo-tricuspid isthmus-dependent intra-atrial macro re-entry circuit eliminated atrial tachycardia and paroxysmal atrial fibrillation without the recurrence of atrial tachyarrhythmia.