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Atrial septal defect (ASD) is one of the most common congenital heart defects found in adults. Percutaneous device closure using the Amplatzer ASD occluder (AGA Medical Corp, Golden Valley, Minn) is widely used for the treatment of ASD and proven to be effective and safe as traditional surgical repair. However, procedure-or device-related complications can occur, which can be fatal. We report a rare case of subacute and silent embolization of an Amplatzer device to the pulmonary artery on the next day of successful percutaneous ASD closure.

The objective of this paper is to describe the novel four-patch technique [modified Brom's] for repair of supravalvular aortic stenosis (SVAS). After transection of the aortaat the sinotubular junction, three longitudinal incisions are made into thethree sinuses. The aortic root geometry was restored by placement ofthree separate patches of autologous pericardium in the opened sinuses. One additional diamond shaped pericardial patch placed anteriorly between proximal and distal aorta. This modified four patch technique provides a complete and symmetric restoration of theaortic anatomy with insignificant gradient and good short-term and potentially good long-term results.

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Purpose Although multiarterial grafting or bilateral mammary artery use is being increasingly emphasized for contemporary coronary artery bypass grafting (CABG) practice, saphenous vein graft (SVG) still accounts for 80% of all CABG conduits (Park et al., 2020) [ 1 ]. In India, both the individual and sequential saphenous grafting techniques are used arbitrarily, and there has not been a study that compares the mid-term patency of these two. This is specially relevant in view of smaller coronaries in Indians than the Caucasian counterparts. This study aims to compare the patency for on pump CABG’s. Methods In the present study, 323 patients underwent either sequential (group A, N = 151 grafts, each graft having two anastomoses each) or individual (group B, N = 344 grafts) saphenous vein CABG, between February 2014 and June 2017. The SVG anastomoses were created on obtuse marginal (OM1/OM2) and posterior descending artery (PDA). The graft patency of the vein grafts as well as the left internal mammary artery were assessed by serial coronary angiograms. Results Results were evaluated at 6 months, 1, 2 and 3 years post operatively. Group A showed a higher graft patency at 3 years at 80.8%, and group B, 67.1% (P = 0.002). Also, anastomoses on sequential conduits had overall better patency rates at three years (77.2% vs 67.2%, P = 0.005). The groups showed similar results at one year post operatively. Conclusions Sequential bypass grafts were associated with superior mid-term patency compared with individual grafts. These findings suggest the more favourable results of sequential bypass grafting to be attributed to the enhanced flow haemodynamics.

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