Hypoplastic right ventricle is a rare congenital disease usually associated with pulmonary atresia or tricuspid atresia. Isolated right ventricular hypoplasia is a rare anomaly without important valvular abnormalities. It is associated with interatrial septal defects leading to the right-to-left shunting of blood. Patients with isolated right ventricular hypoplasia usually have different and variable courses. In some patients, it is recognized in the perinatal period and necessitates prompt intervention; nonetheless, there are some reports of this anomaly in old age with no significant symptoms. In this report, we describe the clinical data and management of 6 adult cases with isolated right ventricular hypoplasia treated medically or surgically based on the severity of the disease and symptoms and then offer an indepth discussion regarding this rare anomaly.

Dear Editor, We are writing to share our observations regarding the article “, Multiple pit defects of unknown etiology in a foldable hydrophobic intraocular lens”,by Thabit et al. [1] We would like to congratulate the authors for documenting this interesting phenomenon. The authors mentioned no obvious reason for the formation of pit-like deposits on the anterior surface of the intraocular lens (IOL). We want to disagree with this statement in that IOL pit formation is a well-established phenomenon where opacification of hydrophilic acrylic IOLs occurs after corneal transplantations such as penetrating keratoplasty and Descemet’, s stripping endothelial keratoplasty (DSEK). [2]..

BACKGROUND: Vermilion irregularities are common secondary deformities after cleft lip repair, regressed or resected hemangiomas, trauma and tumor surgeries. Vermilion deficiency attracts considerable attention and detracts from an otherwise excellent lip repair. Minor and moderate vermilion defects can be corrected with upper lip advancement, rotation flaps, tongue flaps or grafts. Major defects defy correction with local flaps.A technique is described for correction of large absolute tissue defects of the vermilion using Mutual Cross-Lip Musculomucosal Flaps (MCLMF) Or Ahmad-Ali's flaps.METHODS: This technique was applied in eight patients with major vermilion defects secondary to hemangioma regression, neoplasia, and trauma. Reconstruction with MCLMF led to create a balanced donor and recipient lips appearance and function.RESULTS There were no postoperative complications. Surgical results were satisfactory in all patients, and sufficient lip mobility with adequate bulk was maintained. One patient demonstrated minimal transient lip tightening.CONCLUSION: Use of Ahmad-Ali's flaps in selected patients resulted in successful reconstruction of severe vermilion defects.

Background: Despite the favorable history of surgical approach to repair secundum type atrial septal defects (ASDs), the transcatheter closure has increasingly become the preferred strategy because of its relatively high efficacy and lower morbidity compared to surgery in selected cases. However, there is some controversy around the preferred strategy and long‑ term complications of device closure of large ASDs. Here, we evaluated the early and midterm outcomes of adults with large ASDs who underwent transcatheter device closure with devices larger than 28 mm. Methods: A prospective single‑ center study was conducted encompassing all the patients who were 18 years of age or older and underwent device closure for secundum type ASD from 2006 to 2014 with device size of >28 mm, and early and midterm follow‑ up data were assessed. Results: The procedure was successful in 93. 6% of the scheduled patients. Two and a half percent had nonsignificant residual shunt. Immediate device migration occurred in one patient (1. 2%) who underwent surgical retrieval and defect closure. One case of device thrombosis (1. 2%) was seen 1 month after the procedure who had successful medical treatment. There was a case of device erosion 1 month after the procedure referred for the surgery. Mild postintervention pericardial effusion was seen in 16. 5% and reduced to 7. 6% in the first outpatient visit. Conclusions: The study demonstrated that the vast majority of anatomically suitable large ASDs could be closed by using the transcatheter technique with a low complication rate. Therefore, the transcatheter closure could be recommended as the first‑ line strategy in adults with large ASDs. However, meticulous preprocedural imaging and evaluation by experts are necessary before scheduling patients with large ASDs for the percutaneous alternative.