HKSUM CME program 2009 December Acknowledgement: Prof. Hye-Sung Won M.D Department of Obstetrics and Gynecology University of Ulsan College of Medicine,

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HKSUM CME program 2009 December Acknowledgement: Prof. Hye-Sung Won M.D Department of Obstetrics and Gynecology University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea Sponsored by Medison company

Case A prenatal detailed ultrasound examination was performed at 25 weeks’ gestation. A heart CT was subsequently performed. At 38 weeks’ gestation, a baby boy of 2780g with AS 7 at 1 minute and 8 at 5 minutes was delivered vaginally. The baby was admitted to neonatal intensive care unit. Echocardiography, and cardiac surgery was subsequently performed.

VSD LV Lt RV Ao FCV Lt 77.3° 4CV Desc.Ao B-mode Doppler Abnormal vessels LVOT

RA RV LV LA PA Ao SV C Color Doppler Heart computed tomography. a. Three collateral vessels (C1-C3) from descending thoracic aorta. b. schematic picture of collateral vessels.

Questions 1. What are the sonographic abnormalities? 2. What is the likely diagnosis? 3. What are the three collateral vessels as shown on CT?