We report a 47-year-old man who presented with right-sided heart failure. Transthoracic echocardiography revealed a tunnel-shaped communication (ventricular septal defect) between the left ventricle and the right ventricle with a significant left-to-right shunt. The VSD is connected to the lateral wall of the right ventricle by a large tunnel.

We report a 51-year-old female with a history of a degenerated aortic bioprosthesis and severe valvular dysfunction who was admitted for redo valve surgery and unexpectedly developed acute flash pulmonary edema, a dramatic form of cardiogenic pulmonary edema before coronary angiography and was managed by timely and proper treatment.