Fallot's tetralogy with a small patent ductus arteriosus

• 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.

Aorta:

•  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.