Back   Figure 14. Angiography in the right pulmonary artery in anterior/posterior (A) and lateral (B) projections in a patient with absent native central pulmonary arteries following bilateral unifocalizations. A neo right pulmonary artery has been constructed into which the BT shunt is inserted. Note extension of the neo right pulmonary artery anteriorly in front of the airway in the lateral projection.     The reconstructed right pulmonary artery has been brought into the mediastinum and tacked to the ascending aorta. (C), (D).     Angiography in the left pulmonary artery in the same patient. A left BT shunt was inserted into the unifocalized LPA after anastomosing a large MAPCA to the LPA remnant within the lung. The patient underwent complete repair at 16 months of age using a pericardial roll to join the reconstructed right and left pulmonary arteries and a Hancock conduit was placed from the right ventricle to the pericardial roll. 14E,F. Angiogram in AP/cranial (E)  and lateral projections (F)  in the RV outflow tract 1 ½ years after complete repair. RV pressure was 2/3 systemic.
  14G 14H  14I  14J . Peripheral stenoses in the right upper lobe branch and in the distal main RPA (G – anterior/posterior, H – lateral) were dilated with RV pressure decreasing to 55% systemic post dilation (I – anterior/posterior, J – lateral). AP = anterior/posterior, BT = Blalock-Taussig, LPA = left pulmonary artery, MAPCA = major aortopulmonary collateral artery, RPA = right pulmonary artery, RV = right ventricle. Back www.impaedcard.com