Fallot's tetralogy with a small patent ductus arteriosus
A 10 years old female patient with a cyanotic congenital heart disease for preoperative assessment of the pulmonary arteries and their branches.
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- Situs solitus with the apex to the left.
- Atrio-ventricular (AV) and ventriculoarterial (VA) concordance.
- A subaortic ventricular septal defect (VSD) with overriding aorta is noted.
- Cardiomegaly is noted (mainly the right atrium and ventricle).
- Intact interatrial septum.
- The overriding ascending aorta measures about 1.7 cm in its maximum diameter at the level of the main pulmonary artery.
- Left sided aortic arch gives three orderly vessels. The aortic isthmus measures about 1.57 cm in diameter.
- The descending aorta is seen running in the left para-vertebral course and of about 1.10 cm in diameter (at the level of the diaphragm).
- No evident aortic coarcatation.
- The coronary arteries have normal origin and course.
- Small tubular patent ductus arteriosus (PDA) arise from the under surface of the aortic arch to the LPA at its origin; its aortic end measures 0.40 cm & its pulmonary end measures about 0.34 cm
Pulmonary Arteries & Veins
- Confluent hypoplastic main pulmonary artery and its branches arising from the hypertrophied RV.
- The main pulmonary artery measures about 1.13 cm in diameter. The RPA is of uniform caliber that measures about 0.87 cm. The LPA measures about 0.78 cm .
- Prominent pulmonary veins. No evident anomalous pulmonary venous drainage (APVD).
- No evidence of major aorto-pulmonary collaterals (MAPCAs).
Venae Cava & Innominate Veins
- Normal course of the innominate veins and SVC. The IVC joins the inferior suface of the right atrium.
- 1- Lluri G, Aboulhosn JA, Moriarty JM et-al. Applications of cardiac CT in the tetralogy of Fallot patient. JACC Cardiovasc Imaging. 2014;7 (12): 1276-9. doi:10.1016/j.jcmg.2014.04.025 - Pubmed citation
- 2- Siripornpitak S, Pornkul R, Khowsathit P et-al. Cardiac CT angiography in children with congenital heart disease. Eur J Radiol. 2013;82 (7): 1067-82. doi:10.1016/j.ejrad.2011.11.042 - Pubmed citation
- 3- Goitein O, Salem Y, Jacobson J et-al. The role of cardiac computed tomography in infants with congenital heart disease. Isr. Med. Assoc. J. 2014;16 (3): 147-52. Pubmed citation