In patients with CHD after Fontan palliation, there is a lack of a pumping chamber in the pulmonary circulation; thus, pulmonary blood flow and cardiac output are sensitive to increased pulmonary vascular resistance; if obstructive sleep apnoea is present, there are legitimate concerns from continuous positive airway pressure ventilation, which may hinder pulmonary blood flow.

Pulmonary atresia with intact ventricular septum may be complicated by coronary aneurysms and myocardial ischaemia. We report a case of an acquired postoperative right ventricular outflow tract aneurysm with communication to the left ventricular outflow tract. Multimodality imaging helped in the characterisation of this structural abnormality, which led to treatment modification of the patient.

Isolated right superior caval vein drainage into the left atrium is a rare congenital cardiac anomaly usually presenting with hypoxaemia and cyanosis. Surgical repair is the definitive treatment for this condition. In this report, we present the case of a 72-year-old patient with uncorrected anomalous drainage of a right superior caval vein into the left atrium, first diagnosed in the 1960s. To the best of our knowledge, this is the oldest reported unrepaired case.