Stenting and Reimplanting Disconnected Pulmonary Artery in Tetralogy of Fallot Harikrishnan K.N. Kurup, MBBS, MD, Giedrius Baliulis, MD, FRCS, Marcus.

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Stenting and Reimplanting Disconnected Pulmonary Artery in Tetralogy of Fallot Harikrishnan K.N. Kurup, MBBS, MD, Giedrius Baliulis, MD, FRCS, Marcus P. Haw, MBBS, FRCS, Joseph J. Vettukattil, MD, FRCPCH The Annals of Thoracic Surgery Volume 104, Issue 1, Pages e75-e77 (July 2017) DOI: 10.1016/j.athoracsur.2016.06.046 Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Computed tomography angiogram and aortogram demonstrating the ductal diverticulum. (A) The outpouching from the left subclavian artery soon after its takeoff from the aorta demonstrates an outpouching labelled “ductal diverticulum” which corresponds to the angiographic appearance (B). This represent the stump of the DA and potential for continuity with the disconnected LPA. (LV = left ventricle; RPA = right pulmonary artery.) The Annals of Thoracic Surgery 2017 104, e75-e77DOI: (10.1016/j.athoracsur.2016.06.046) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Fluoroscopy shows the guidewire placed in the left pulmonary vasculature after stenting the discontinuous proximal left pulmonary artery. The Annals of Thoracic Surgery 2017 104, e75-e77DOI: (10.1016/j.athoracsur.2016.06.046) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Angiogram following the procedure depicting optimal flow into the left pulmonary artery (LPA). (A) Angiogram prior to stent angioplasty and (B) post-procedure angiogram showing unobstructed flow into the stented LPA. The Annals of Thoracic Surgery 2017 104, e75-e77DOI: (10.1016/j.athoracsur.2016.06.046) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions