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(Circulation. 1998;98:2930-2931.)
© 1998 American Heart Association, Inc.

Images in Cardiovascular Medicine

Combined Angiography and Three-Dimensional Computed Tomography for Assessing Systemic-to-Pulmonary Collaterals in Pulmonary Atresia With Ventricular Septal Defect

Emmanuel Le Bret, MD; Loïc Macé, MD; Patrice Dervanian, MD; Thierry Folliguet, MD; Armand Bourriez, MD; Joy Zoghby, MD; Virginie Lambert, MD; Jean Losay, MD; Yves Martin-Bouyer, MD; Jean Yves Neveux, MD

From the Department of Cardiovascular and Cardiopediatric Surgery, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France.

Correspondence to Loïc Macé, MD, Department of Cardiovascular and Cardiopediatric Surgery, Centre Chirurgical Marie Lannelongue, 133 avenue de la Résistance, 92350 Le Plessis Robinson, France.

A12-month-old child was evaluated for pulmonary atre-sia with ventricular septal defect. Assessment of the whole arterial pulmonary arborization was first done by angiography. This examination revealed that the left lung received vascularization by the native pulmonary artery via a central shunt performed during the neonatal period and by 2 aortopulmonary collateral arteries. The positions of these 2 arteries and their spatial relationship with the left bronchus were clearly visualized before unifocalization by 3-dimensional CT.

View larger version (114K): [in this window] [in a new window]   Figure 1. Visualization of the collateral arteries by angiography. Top, Left superior collateral (s) seems to arise from anterior aspect of aorta from a main truncus with right superior collateral. Bottom, Left inferior collateral (i) seems to arise from left side of aorta; its position from bronchus cannot be evaluated.

View larger version (73K): [in this window] [in a new window]   Figure 2. Visualization of collateral arteries by three-dimensional CT. A, Left superior collateral (s) arises from anterior aspect of aorta by a main truncus that passes under carena and then appears in front of left bronchus under native pulmonary artery (PA). B, Left inferior collateral (i) arises from left side of aorta, making a loop behind left main truncus, and then crosses inferior aspect of bronchus.

Footnotes

The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke's Episcopal Hospital and Texas Heart . . . [Full Text of this Article]