Surgical treatment following transcatheter intervention in an adult patient with supravalvar mitral ring, large patent ductus arteriosus and severe pulmonary hypertension

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Supravalvar mitral ring (SVMR) is a rare cause of congenital mitral stenosis. It can occur in isolation but often coexists with other cardiac anomalies [1]. Conversely, a patent ductus arteriosus (PDA) is a much more common anomaly. In terms of cardiac hemodynamics, pulmonary arterial hypertension (PAH) can occur if there is left-sided obstruction by SVMR or high pulmonary blood flow by PDA. But the coexistence of both mechanisms is very rare. We herein introduce a case of a 23-year-old female with SVMR, a large PDA, supracristal ventricular septal defects (SPVSD) and severe PAH.