Fallot's tetralogy with a small patent ductus arteriosus

Case contributed by Dr Mohammad A. ElBeialy


A 10 years old female patient with a cyanotic congenital heart disease for preoperative assessment of the pulmonary arteries and their branches.

Patient Data

Age: 10 Years
Gender: Female

  • Heart:
  • 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.


Case Discussion

Fallot  tetralogy with  small PDA

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Case information

rID: 34254
Case created: 11th Feb 2015
Last edited: 16th Dec 2015
System: Cardiac
Inclusion in quiz mode: Included

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