Costello syndrome is a rare congenital disease caused by activating germline mutations, and it is often associated with cardiac abnormalities. A 17-year-old male, who had a history of Costello syndrome, presented with persistent fever. The vegetation attached to anterior mitral leaflet was detected, and antibiotic therapy was administered as treatment for infectious endocarditis. However, it was difficult to manage his heart failure owing to the worsening of mitral valve regurgitation. Therefore, mitral valve repair with vegetation resection was performed. His hypertrophic cardiomyopathy and systolic anterior motion caused left ventricle outflow tract obstruction. A floating stitch on the anterior mitral leaflet from the posterior ring annulus was effective. Herein, we report a successfully repaired case of infectious endocarditis on the mitral valve with hypertrophic cardiomyopathy complicated by Costello syndrome.

Although the surgical technique for acute type A aortic dissection markedly improved in the last decade, perioperative mortality and morbidity rates remain dramatically high. Therefore, we introduce the novel “plaster technique” using the single interrupted suture with a felt and plastering the minimum dose of BioGlue® (Cryolife Inc., Kennesaw, GA, USA) into the suture hole in this report. We found that the plaster technique using a felt pledget and minimum dose of BioGlue is effective for fragile aortic walls, as in patients undergoing acute aortic dissection and is a simple, safe, and durable technique to strengthen the suture line.

A 40-year-old woman underwent an atrial septal defect closure with juxtaposition of the atrial appendages without communication between both appendages 4 years before presentation. She recently experienced desaturation on exercise, and right-to-left shunt coming from the residual communication between both appendages was found. The residual communication was closed from the right to the left atrium. Herein, we report a rare case of juxtaposition of the atrial appendages with residual communication between them after an atrial septal defect closure.

Cor triatriatum is a rare congenital heart disease. A 57-years-old woman had cor triatriatum with severe mitral valve regurgitation (MR) and atrial fibrillation (AF). We perfomed mitral valve repair, left atrial appendage resection, and maze procedure by resection of the anomalous septum in the left atrium. At result, MR was controllable and AF disappeared after the operation. Although there is no established maze procedure with cor triatriatum, removing the septum was effective to complete it.