Vascular access-related complications are an important consideration in patients undergoing cardiac catheterisation. Patients with CHD are increasingly undergoing percutaneous treatment for suitable procedures as an alternative, less invasive option to surgical intervention. As such, recognition and treatment of these complications are becoming increasingly important. We present a case of a patient with repaired Tetralogy of Fallot who developed a femoral arteriovenous fistula and femoral artery pseudoaneurysm arising from an accessory arterial branch following percutaneous Harmony valve implantation, both of which were treated endovascularly with placement of a stent.

Pulmonary arteriovenous fistula is a rare vascular anomaly that can cause significant morbidity and mortality. The presence and significance of symptoms are dependent on the size of the right-to-left shunt. Thromboembolic events may result in cerebrovascular accidents or systemic vascular occlusions. We present a case of an adolescent without cardiorespiratory symptoms, who developed flank pain due to renal infarction, followed by a brief literature review.

In an 11-year old boy with a large coronary arteriovenous fistula between the left coronary artery and the right atrium, we achieved successful closure using a 10–8 Amplatzer Duct Occluder introduced from the right internal jugular vein. Angiography 6 weeks later showed complete occlusion of the fistula, with normal opacification of the left coronary arterial system. This technique may be used as an alternative to coils and surgery in selected patients.

A fistula from the pulmonary artery to the left atrium is a very rare congenital anomaly. The communication, almost exclusively arising from the right pulmonary artery, may give rise to a variety of symptoms with cyanosis as the predominant sign. To our knowledge only seven neonates have been reported with this anomaly, and five of them died postoperatively. We present another two neonates with such a fistula which was closed by simple ligation using a transsternal approach and cardiopulmonary bypass. Both patients had an uneventful postoperative course and are alive and well at the age of two and three years, respectively.

Following trauma to her right frontal region, a 68-year-old woman suffered bilateral, benign, paroxysmal, positional vertigo and a left-sided, longitudinal petrosal bone fracture, with secondary facial palsy and ossicular luxation. From the onset, the patient complained of pulsatile, left-sided tinnitus. After eight weeks, she developed left-sided ocular symptoms, progressing from conjunctival hyperaemia and orbital oedema to an abducens nerve palsy, and ultimately to heart failure.

The case and the final diagnosis of carotico-cavernous fistula are discussed. Guidelines are proposed for a diagnostic approach to pulsatile tinnitus and for the optimal management of patients presenting with pulsatile tinnitus associated with ocular symptoms.

A young woman with surgically treated tetralogy of Fallot with pulmonary atresia, with multiple aorto-pulmonary collateral arteries, developed an arteriovenous fistula subsequent to transvenous insertion of an automatic implantable defibrillator via the left subclavian vein. The fistula extended between this vein and a systemic-to-pulmonary collateral artery arising from the subclavian artery. Unilateral peau d'orange, and painful congestion of the left arm and breast, ensued. These were cured by coil embolization of a fistula-related aneurysm.

Arteriovenous fistula of the superficial temporal artery is a rare condition most commonly caused by trauma. Traditional surgical treatment has been superseded by endovascular embolization. We present the case of a 40year-old man with a traumatic arteriovenous fistula of the superficial temporal artery who was treated by endovascular embolization. The advantages of this approach are discussed, along with a brief history of the condition

Treatment of auricular arteriovenous fistula (AVF) is a challenge with surgery being the preferred option until now. We present three cases of auricular AVFs who underwent pre-operative embolization and its outcome on surgery. Three patients were diagnosed to have auricular AVF by angiography. All three patients underwent pre-operative embolization with n-butyl 2-cyanoacrylate after which they underwent surgical resection of the AVF. Pre-operative embolization resulted in significant devascularization of the AVF thus leading to near bloodless and clean surgery. Pre-operative embolization of auricular AVFs is a good treatment option, leading to significantly reduced blood loss during surgical excision.

Fistulae between major vessels in the head and neck are uncommon. In both civilian and wartime reports, the total number of traumatic arterio–venous fistulae in head and neck region account for less than four per cent of all arterial injuries. Fourteen cases of congenital communication between the external carotid artery and external or internal jugular vein have been reported. We report and discuss the management of a case of ruptured carotico–jugular fistula secondary to infection which presented as acute upper airway obstruction. This appears to be the first description of such a case in the literature.