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Imaging in Pulmonary Atresia with Ventricular Septal Defect

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CT and MRI in Congenital Heart Diseases

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Abstract

Pulmonary atresia with ventricular septal defect (PA-VSD) is well recognized as a separate group of diverse congenital malformations resulting from an absence of luminal continuity between the ventricle and the pulmonary arteries in the presence of a ventricular septal defect (VSD). Compared to classic Tetralogy of Fallot (TOF), PA-VSD often has surgical challenges and relatively poorer outcomes due to variable pulmonary blood flow. Advances in cross-sectional imaging techniques like computed tomography (CT) and magnetic resonance imaging (MRI) have revolutionized the management of patients with PA-VSD by presenting a comprehensive evaluation of anatomic structures, including the heart, pulmonary and systemic thoracic vasculature, lungs, and abdomen. The use of multiplanar and 3D CT reconstruction images helps the clinicians and operating surgeons understand the morphology and its impact on management. Multi-detector CT (MDCT) and Magnetic resonance imaging (MRI) complement echocardiography and increasingly substitute for invasive angiography in the management of PA-VSD.

Three different MRI cases of PA-VSD with the full report are available at online-only video files.

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Author information

Authors and Affiliations

  1. U.N. Mehta Institute of Cardiology and Research Centre, Ahmedabad, Gujarat, India

    Yashpal Rana

  2. Radiscan Diagnostics, Ahmedabad, Gujarat, India

    Yashpal Rana

  3. Department of Radiology, Amrita School of Medicine, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India

    Ramiah Rajeshkannan

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  1. Yashpal Rana
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Editor information

Editors and Affiliations

  1. Department of Radiology, Amrita School of Medicine, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India

    Ramiah Rajeshkannan

  2. Department of Cardiothoracic imaging, Narayana Hrudayalaya, Bangalore, Karnataka, India

    Vimal Raj

  3. Department of Radiology, Sri Sathya Sai Institute of Higher Medical Sciences, Bengaluru, Karnataka, India

    Sanjaya Viswamitra

1 Electronic Supplementary Material

Cor cine

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3D SSFP

4Ch cine

AORTA_PC

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Ball AORTA_PC

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Video 10.1

CMR in long segment pulmonary atresia with VSD. Protected right side MAPCA, unprotected left side MAPCA. Hemodynamics of pulmonary circulation were discussed (PDF 1441 kb)

Video 10.6

CMR in Congenitally corrected TGA, VSD, Pulmonary atresia, PDA to distal RPA with RPA stenosis. Status post BDGS with PA plasty and PDA division (PDF 63 kb)

Video 10.16

CMR in 5 years old child with TOF-pulmonary atresia. Status post PDA stunting (PDF 502 kb)

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Rana, Y., Rajeshkannan, R. (2021). Imaging in Pulmonary Atresia with Ventricular Septal Defect. In: Rajeshkannan, R., Raj, V., Viswamitra, S. (eds) CT and MRI in Congenital Heart Diseases. Springer, Singapore. https://doi.org/10.1007/978-981-15-6755-1_10

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