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Pediatric Cardic Problem
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Pediatric Cardic Problem

am enclosing herewith the details of the CTANGIO what medication to be carried out
CT-ANGIOGRAM STUDY OF THE AORTA & PULMONARY ARTERIES

What will we do for the following findings in the CT angio

CARDIAC APEX
The Cardiac apex is detected on the left side (Levocardia) with leftward rotation

SITUS OF ATRIUM AND SYSTEMIC VENOUS DRAINAGE
Atrial situs solitus.  The SVC drains into right atrium.  The IVC drains into right atrium.  The 4 pulmonary veins are draining into left atrium

ATRIO VENTRICULAR ARRANGEMENT
Concordant

VENTRICULO ARTERIAL ARRANGEMENT
Overriding of aorta (50% to the RV).  The pulmonary artery arises from the right ventricle

ATRIA AND VENTRICLES
The RA and RV is dilated.  The interatrial septum is intact.  There is subaortic membranous VSD

RVOT and PULMONARY ARTERY
The Pulmonary arteries are confluent.  The main pulmonary artery is atretic.  The right pulmonary artery measures 4.8mm.  The left pulmonary artery proximal end measures 4.0mm and mid LPA measures 6.2mm.  There is focal dilation of mid LPA segment the point at which aortopulmonary collateral drains into LPA

AORTA
The aortic arch is left sided.  The ascending aorta measures 18X18mm, descending aorta measures 11 X 11 mm.  The origins of great vessels appear normal.

ABDOMINAL ORGANS
Normal abdominal situs

MAPCAS
There are 4 major aorto pulmonary collaterals noted, 2 supplying exclusively the right lung measuring 3.9mm and 3.7mm respectively.  The left lung is supplied exclusively by one collateral measuring 5.3mm at its origin.  There is one more collateral that is seen to supply both the right and left lung fields measuring 4.3mm at its origin.

IMPRESSION

* NORMAL ATRIAL AND ABDOMINAL SITUS SOLITUS

* OVERRIDING OF AORTA, MEMBRANOUS VSD.

* AV CONCORDANCE

* ATRETIC MAIN PULMONARY ARTERY

* 4 MAJOR AORTOPULMONARY COLLATERALS NOTED SUPPLYING THE RIGHT AND LEFT LUNG FIELDS
Related Discussions
773637_tn?1327450515
Dear Jk,

The anatomy described above is tetraology of Fallot with pulmonary atresia and multiple aortopulmonary collateral arteries.  Without evaluating your child or having any other information about him/her, I cannot say what needs to be done right now.  I can say that, to survive, this baby will require at least one, and possibly more than one, heart surgery.  Therefore, I recommend that your child be evaluated by a pediatric cardiologist who has experience managing this lesion and who has access to a pediatric cardiac surgeon who has experience with this, as well.
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This Forum's Experts
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Marie M Gleason, M.D.Blank
The Children’s Hospital of Philadelphia
Philadelphia, PA
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Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
Philadelphia, PA
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