This is a 3-years old child with Tetralogy of Fallot (TOF) with pulmonary atresia (PA) who underwent a unifocalization surgery. A conduit was fashioned from the RV and attached to two MAPCAs, one to the right lung and one to the left lung, which were made to serve as the RPA and LPA respectively. One large MAPCA to the right lung was left behind.
On repeat echo, the neo-RPA could not be visualized and a cardiac CT was performed to confirm patency of all vessels.
The CT (Figs. 1, 2) showed the conduit (white arrow) and the neo-RPA (blue arrow - Fig. 1) and neo-LPA (blue arrow - Fig. 2), well. The large remaining MAPCA (red arrow - Fig. 3) was also well seen. However, when color coding in 3D was used to look at the vessels, the anatomy became crystal clear. The conduit and neo-RPA and neo-LPA are in blue, whereas the aorta and MAPCA are in red (Figs. 4, 5). In the evaluation of pulmonary arteries and MAPCAs, the use of this rendering technique makes it much easier to understand the anatomy of the pulmonary arteries, MAPCAs and other related vessels.
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