Although mid- and long-term outcomes after the Ross procedure for aortic valve disease have been increasingly improving over the years, this is still a rather challenging operation in neonates and small children. This is particularly true for patients with associated congenital heart defects and critical clinical conditions. Herein we describe the application of this procedure as a rescue operation in emergency circumstances in a low-birth-weight neonate with severe aortic stenosis, aortic regurgitation and mitral regurgitation after a previous aortic coartectomy.

Takotsubo syndrome is a rare and serious condition, often induced by major physical or psychological stress. Both its diagnosis and treatment could be challenging; herein we describe a complex case of Takotsubo syndrome following mitral valve repair surgery associated with occurrence of systolic anterior motion of the mitral valve , severe mitral regurgitation, consequent right heart failure and its peculiar clinical management.