Back   10A: Selective angiogram in a MAPCA in a three month old shows the severely hypoplastic native pulmonary arteries, which measure at most 1 mm in diameter.   10B: Lateral projection of the same angiogram showing the tiny central pulmonary arteries extending anteriorly.   10C: Pulmonary artery angiogram in the same patient at 18 months of age after a Melbourne shunt at three months of age and left unifocalization with placement of a 4 mm left BT shunt at 11 months of age.   10D: Lateral projection of the same angiogram performed via the left BT shunt. Note the dramatic increase in size of the central pulmonary arteries. The catheter course is from the left BT shunt into the central pulmonary arteries, and then through the Melbourne shunt into the ascending aorta. The catheter is pulled back towards the pulmonary arteries during the injection. The patient underwent complete repair at 2 ½ years of age.   10E, F. Pulmonary angiogram in the same patient at 3 ½ years of age, one year after complete repair. She underwent dilation of left middle and left lower lobe branches with RV pressure decreasing from ¾ systemic to 2/3 systemic. BT = Blalock-Taussig, MAPCA = major aortopulmonary collateral artery, RV = right ventricle. Back www.impaedcard.com