Total anomalous pulmonary venous return with obstruction to the venous pathway is a life-threatening emergency. We report a neonate with unusual infradiaphragmatic drainage into the ductus venosus and gastric veins. Neonatal gastric varices with obstructed pulmonary venous return are extremely rare with potential for catastrophic gastrointestinal haemorrhage. The complex anatomy first detected by echocardiography was clarified on CT.

We report the smallest case of the balloon aortic valvuloplasty via a carotid artery. A baby boy weighing 890 g suffered from a severe aortic stenosis. Balloon aortic valvuloplasty using a TMP-Ped 4-mm balloon catheter succeeded in resolving severe aortic stenosis without any complications. Balloon aortic valvuloplasty via a carotid artery can be a first-line treatment even for extremely-low-birth-weight infants.

Cardiac tumours are relatively uncommon, particularly in children. Myofibroma is an extremely rare variety of cardiac tumour, which nearly always arises in the context of infantile myofibromatosis. Herein, we present a case of a solitary cardiac myofibroma causing right ventricular outflow tract obstruction in a 2-month-old male infant.

Total anomalous pulmonary venous connection is a rare congenital heart defect. We report an infant with a mixed form of supracardiac TAPVC, in whom all pulmonary veins, except the right upper, entered a pulmonary venous confluence that is connected to a vertical vein and drained into the superior vena caval–right atrial junction. Several segmental right upper pulmonary veins entered the superior vena cava, superior to the entry of the vertical vein. Surgical repair consisted of the Warden procedure combined with direct anastomosis of the vertical vein to the left atrium. Separate pulmonary venous drainage pathways decreased the risk of post-operative pulmonary venous obstruction. Our patient had an uneventful post-operative course and encouraging 2-month follow-up echocardiography. Careful follow-up is warranted to detect post-operative complications, including obstruction of the pulmonary venous and cavoatrial anastomoses.

Right atrial isomerism is associated with complex cardiac malformations, particularly single-ventricle lesions; right atrial isomerism is rarely associated with aorto-pulmonary collateral arteries. We report a foetal diagnosis of right atrial isomerism, with an unbalanced atrioventricular septal defect, pulmonary stenosis, total anomalous venous drainage, and significant aorto-pulmonary collaterals diagnosed at 22 weeks’ gestation.

The differential diagnosis of a left atrial mass on echocardiogram includes thrombus, vegetation, tumour, and other rare causes like septal aneurysm, pulmonary vein remnant, and septal haematoma. We present interesting echocardiographic images of a rare condition which can masquerade as a left atrial mass following cardiac surgery.

Arteriovenous malformations may present with significant haemodynamic compromise in the neonatal period, typically with high output cardiac failure that may be accompanied by hypoxia and right ventricular dysfunction. Targeted neonatal echocardiography performed by trained neonatologists provides an enhanced physiology-based approach that can guide treatment and minimise complications. We present a case of a large hepatic vascular malformation whose therapy was guided by targeted neonatal echocardiography to prevent paradoxical embolisation of procedural glue to the systemic circulation.

Mammalian target of rapamycin inhibitors was found recently to be an effective treatment for manifestations of Tuberous sclerosis complex, including cardiac rhabdomyomas. Most cases with Cardiac rhabdomyoma treated with mammalian target of rapamycin inhibitors to date were diagnosed with Tuberous sclerosis. We report a case of cardiac rhabdomyoma and severe right ventricular outflow obstruction in a baby with negative genetics for Tuberous sclerosis that responded rapidly to Sirolimus.

We report a case with Ebstein’s anomaly and pulmonary atresia with sustained monomorphic ventricular tachycardia in a patient without a ventriculotomy history. In the low voltage area between the atrialised right ventricle and hypoplastic right ventricle, there was a ventricular tachycardia substrate and slow conduction. The tachycardia circuit was eliminated by a point catheter ablation at the area with diastolic fractionated potentials.

The SARS-CoV-2 (COVID-19) pandemic has challenged our initial predictions of its ramifications, both short and long term. Cardiovascular manifestations of COVID-19 in children remain a topic of investigation as literature is lacking. We describe new onset atrial fibrillation in a child with a history of COVID-19 infection. Understanding of cardiogenic effects of COVID-19 can help minimise the delay in diagnosis.

Vitamin C deficiency has been a historical disease rarely seen nowadays. We illustrate a case of a boy with autism presenting with severe pulmonary hypertension and refusal to walk secondary to vitamin C deficiency. Initiating treatment with high-dose vitamin C reversed his symptoms and he regained full power of his lower limbs with total normalisation of his pulmonary pressures.

We describe an infant with duct-dependent hypoplastic left heart complex with moderate hypoplasia of the left ventricle and aortic arch who was not operated due to resource limitations. The left-sided structures grew remarkably due to favourable loading condition changes of the left ventricle, allowing weaning from prostaglandin at the age of 3 months and discharging the patient without intervention.