In patients with an ASD and significant PAH and/or restrictive LV physiology as well as in Fontan patients with a large surgically created fenestration but failing Fontan circulation, a partial closure with a self-fenestrated Amplatzer device can be a feasible and successful therapeutic option. Balloon-dilated fenestrations in the Amplatzer device tend to close spontaneously during follow-up. Nonresorbable sutures or stenting can ensure patency of the created holes.

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Stent implantation to treat pulmonary artery stenosis in pediatric patients with CPC is effective and can be realized safely. Close follow-up is recommended in patients with risk for pulmonary artery stenosis. During total cavopulmonary connection, previously implanted stents at that site should be left in place or be changed in a hybrid procedure to a larger diameter, because the etiology of stenosis may persist after surgery and the surgical removal could result in vessel injury that promotes restenosis.

ABTRACT.Constrictive pericarditis is an uncommon condition, often of unknown etiology. The diagnosis of constrictive pericarditis can be difficult and is often delayed, because the signs and symptoms of this disease can be falsely attributed to other causes. We report the case of a 62-year-old woman presented with a one year history of progressively worsening dyspnea, peripheral oedema, prominent jugular distension, hepatomegaly, ascites. The patient is known with a history of effusive pericarditis. Blood test showed a normal white cell count, anaemia, raised CRP. Chest X-Ray shows a normal sized heart and without calcification of the pericardium. The echocardiographic exam showed septal bounce-abrupt transient rightward movement, left, right ventricular size decreased-heart tubularin shape, mild atrial enlargement, IVC plethoric and unresponsive to respiration, hepatic veins dilated. Doppler echocardiographic findings were consistent with constrictive pericarditis. Cardiac catheterization showed elevation and equalization of diastolic filling pressures, and dips and plateau configuration of ventricular pressure during diastole (square root sign). Based on these results pericardiectomy was necessary.

Turner syndrome (TS) is the most common chromosomal abnormality affecting females and cardiac abnormalities have been described in up to 50% of patients. Although coarctation represents one of the most frequent cardiac malformation, treatment options in these patients represent an area of debate, due to associated aortopathy and risk for aortic dissection. In addition to the contradictory data found in the literature, regarding the safety profile and utility of stenting of coarctation of the aorta in TS patients, we present the case of a patient of pediatric age, who successfully underwent the procedure, being free from periprocedural and short-term complications. Beside the presentation itself, we aimed to review and summarize the data available in the literature regarding this topic. As a conclusion, we emphasize the role of minimally invasive interventional therapy and wish to underline the need of further, larger scale studies and guidelines in this patient group. Given the related aortopathy, all preventive measures should be undertaken to avoid aortic dissection during stent implantation in this vulnerable population. Although the evolution of our patient was favorable, data found in the literature is somewhat contradictory and a close follow-up is indicated to help evaluate the risk of long-term complications.

Introduction: Coarctation of the aorta represents a narrowing of the thoracic aorta. Hypertensive patients with blood pressure differences ≥20 millimetres of mercury have an indication for surgical or interventional treatment. Implantation of a covered stent became the preferred therapy for the management of this pathology in adolescents/adults. Case report: We report the case of a 14-year-old male sportsman, who presented in the emergency room with headache, dizziness, and tinnitus. The clinical exam revealed blood pressure differences between the upper and lower limbs of up to 50 mmHg. Based on the clinical and paraclinical data, we established the diagnosis of coarctation of the aorta and severe secondary arterial hypertension. The case was discussed by a multidisciplinary team and accepted for covered stent implantation. The 24 h blood pressure Holter monitoring after the procedure indicated the persistence of stage I arterial hypertension. Conclusions: Coarctation of the aorta is a congenital cardiovascular anomaly with high morbidity and mortality rates. Arterial hypertension, heart failure, and aortic dissection are complications of this pathology, some of them being sometimes direct consequences of secondary hypertension. Periodic cardiology follow up after the procedure is mandatory to assess the hemodynamic response, to identify potential complications, and to stratify the cardiovascular risk.

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Introduction Acute thrombosis of the modified Blalock-Taussig shunt (mBTS) in patients with univentricular physiology is a life-threatening event. Case presentation We present a case of acute mBTS thrombosis complicating a hemodynamic evaluation before a bidirectional Glenn procedure for tricuspid atresia. After failed balloon angioplasty and catheter-directed selective thrombolysis, the patient was successfully managed by stent implantation into the thrombosed shunt. To the best of our knowledge, this was the first case of acute mBTS thrombosis treated by catheter intervention in Romania. Conclusions Even a routine invasive hemodynamic evaluation might be complicated by a life-threatening condition. Stent implantation in the setting of acute mBTS thrombosis could be lifesaving.