Prenatal diagnosis of hypoplastic aortic arch and coarctation of aorta is still challenging and remains one of the most difficult cardiac defect to diagnose. The results reveal significant improvement of prenatal diagnosis of hypoplastic arch and coactation of aorta. The data also shows the significant overlapping of fetal aortic isthmus z score between the infants who need the arch procedure and those who do not.

Cervantes-Salazar and colleagues report the long-term surgical outcomes of 414 patients with total anomalous pulmonary venous connection (TAPVC) from January 2003 to June 2019. With an overall survival rate of 87.2% from 2003 to 2019, the authors found that an increased mortality risk was associated with infra-cardiac TAPVC, pulmonary venous obstruction (PVO), and postoperative mechanical ventilation. Their comprehensive study with a large sample size of varying age groups, and patients with late referrals for surgery, provide valuable insight into TAPVC surgical outcomes. Improved survival for these patients continues to be a major goal of clinical teams striving to transform treatment paradigms. The comprehensive and promising results of the study reported by Cervantes-Salazar and colleagues gives our field hope for a better future for these patients.

Total Anomalous Pulmonary Venous Connection combined with Single Ventricle represents a cardiac and extra-cardiac diagnosis that may benefit from alternative additional imaging to reach a complete anatomical diagnosis and continued treatment strategy.

WeChat and access to wireless communication may offer a continuum of care following medical and surgical intervention. This cardiac surgery research study evaluates the process of parental education and social support following pediatric cardiac surgery utilizing standard of care compared to telehealth.

Multi-disciplinary teams present the framework in the increasingly challenging care provided for patients. Wang et al. present a 37 year old female who is 35 weeks pregnant when a rare cardiac angiosarcoma is diagnosed.

Bas et al. report the clinical measurement, using High Performance Liquid Chromatography (HPLC), of asymmetric dimethyarginine in two groups of patients undergoing aortic coarctation repair.

Kozyrev et al. report their results in a modified technique for coarctation of aorta with hypoplastic distal aortic arch (1). This paper represents a quality initiative as much as a technical manuscript. The authors included 32 patients during a three year time period from 2016 until 2019.

Introduction: In adult congenital patients with transposition of the great arteries originally treated with the Mustard (atrial switch) procedure, the most common reason for re-intervention is baffle stenosis. This may be exacerbated by permanent transvenous pacemaker lead placement across the baffle. Case Report: A 47-year-old female status post Mustard procedure performed at 15 months old presented with a high-grade stenosis of the superior vena cava (SVC) baffle from the SVC to the left atrium, with a nonfunctional permanent pacemaker lead passing through the baffle. A mechanical rotating dilator sheath was used for attempted lead extraction, relieving the baffle stenosis almost completely as a secondary effect, prior to the placement of a 10 x 27 mm Visipro balloon expandable stent in the SVC baffle. Conclusions: Use of the mechanical rotating dilator sheath is an evolving treatment strategy in adult congenital heart disease to minimize the risk of bleeding, trauma to surrounding structures, and death. Its ability to fully alleviate baffle stenosis even when full lead extraction is not feasible or is associated with significant procedural risk further demonstrates its expanded role in this patient population. A multidisciplinary approach and great diligence must be employed to avoid potential complications.