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A 56-year-old female presented to us with rheumatic mitral stenosis with a left atrial clot. We found one coronary cameral fistula on the coronary angiography from the posterior left ventricular branch to the left ventricle. She was taken up for surgical mitral valve replacement and clot removal. A residual coronary fistula may increase the risk of infective endocarditis, especially in the presence of mechanical prosthesis. Henceforth, intra-operatively, we used the methylene blue dye injection as an easy technique to detect and safely close the coronary fistula from inside the left ventricular chamber. She recovered smoothly with a successful outcome., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Percutaneous closure of patent ductus arteriosus using a duct occluder has become standard of care in its management especially in children more than 6 months of age, weighing more than 6 kg but device embolisation is a potential life-threatening complication and may require immediate open-heart surgery. We describe a case of successful surgical management of a patient in early childhood, in which device has embolised deep into the right pulmonary artery., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

Aspergilloma usually grows in lung cavities, although some may present with intrabronchial masses. Bronchial spillage during surgery is a known and disastrous complication of cavitary aspergilloma with bronchial communication. We present a case of a man in his 40s who developed a cavitary aspergilloma with recurrent haemoptysis almost a decade after his pulmonary tuberculosis. Following a segmentectomy for the same, the patient was extubated on table with well-expanded lung fields. Six hours later, he developed respiratory distress, and X-ray showed a complete lung collapse. An emergency bronchoscopy revealed a fungal ball obstructing the left main bronchus. The mass was successfully removed through bronchoscope, and the patient had lung expansion and uneventful recovery., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2023. No commercial re-use. See rights and permissions. Published by BMJ.)