Major Aortopulmonary Collaterals in Transposition of the Great Arteries: A Cause for Preoperative and Postoperative Hemodynamic Imbalance Massimiliano.

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Presentation transcript:

Major Aortopulmonary Collaterals in Transposition of the Great Arteries: A Cause for Preoperative and Postoperative Hemodynamic Imbalance Massimiliano Cantinotti, MD, Raffaele Giordano, MD, Alberto Clemente, MD, Bruno Murzi, MD, Nadia Assanta, MD, Alessia Lunardini, MD, Isabella Spadoni, MD The Annals of Thoracic Surgery Volume 102, Issue 1, Pages e33-e35 (July 2016) DOI: 10.1016/j.athoracsur.2015.11.025 Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 A large collateral originating from the right subclavian artery (RSA) and supplying the superior lobe of the right lung. (A) Echocardiographic suprasternal view. (B) Computed tomography angiography maximum intensity projection oblique image. (C) Angiographic view; selective injection with contrast filling. (Ao Arch = aortic arch.) The Annals of Thoracic Surgery 2016 102, e33-e35DOI: (10.1016/j.athoracsur.2015.11.025) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Selective angiography with contrast filling of a large collateral from the aortic (Ao) arch serving the right middle and inferior lobes. (B) Computed tomography (CT) angiography maximum intensity projection coronal image showing the distribution toward the right pulmonary hilum with multiple side branches. (C) Three-dimensional volume-rendering “cut-plane” image showing the arterial collateral branches from the subclavian artery (white arrow) and the aortic arch (black arrow). (D) Selective injection with contrast filling of a large collateral from the thoracic aorta to the left lung. The coil occluding the collateral from right subclavian artery (RSA) (A and B) and the plug occluding the collateral from the aortic arch are shown (B). CT images: volumetric prospective electrocardiographically gated (40% R-R interval) CT acquisition with a 320-row CT scanner (Toshiba Aquilion One, Toshiba Medical System, Tochigi-ken, Japan) with intravenous administration of iodinated contrast by the antecubital vein. The Annals of Thoracic Surgery 2016 102, e33-e35DOI: (10.1016/j.athoracsur.2015.11.025) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions