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• W2028787802 abstract "HomeCirculationVol. 109, No. 3Diagnosis of Hemi-Truncus Arteriosis by Three-Dimensional Magnetic Resonance Angiography Free AccessReview ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessReview ArticlePDF/EPUBDiagnosis of Hemi-Truncus Arteriosis by Three-Dimensional Magnetic Resonance Angiography Reza Razavi, MRCP, Marc Miquel, PhD and Edward Baker, MD FRCP Reza RazaviReza Razavi From the Department of Paediatric Cardiology, Guy’s Hospital, London, UK. Search for more papers by this author , Marc MiquelMarc Miquel From the Department of Paediatric Cardiology, Guy’s Hospital, London, UK. Search for more papers by this author and Edward BakerEdward Baker From the Department of Paediatric Cardiology, Guy’s Hospital, London, UK. Search for more papers by this author Originally published27 Jan 2004https://doi.org/10.1161/01.CIR.0000113459.16277.D5Circulation. 2004;109:e15–e16Two patients, aged 3 days (weight 2 kg) and 40 years (weight 80 kg) underwent gadolinium-enhanced magnetic resonance angiography (MRA) because of diagnostic uncertainty. The newborn infant was antenatally diagnosed with truncus arteriosis. Postnatal echocardiography confirmed the diagnosis. It was thought that the branch pulmonary arteries were confluent (type II); however, an MRA was requested to clarify this. The MR angiograms (Figure 1) showed the right pulmonary artery arising from the left side of the ascending aorta. The left pulmonary artery, which was disconnected from the right pulmonary artery, was supplied by the patent ductus arteriosis arising from the underside of the aortic arch. The MRA findings were confirmed at surgery. Download figureDownload PowerPointFigure 1. Three-dimensional reconstructed MRA of the new-born patient. Blue shows the superior vena cava, pulmonary veins, right and left atria, and right ventricle. Red shows the aorta and main branches, right pulmonary artery (RPA), and left ventricle. Orange shows the patent ductus arteriosis and left pulmonary artery. A, Posterior view. B, Posterior view without the descending aorta showing the disconnected left and right pulmonary arteries. C (anterior view) and D (left lateral view) show the RPA arising from the left side of the ascending aorta. Reconstruction was performed off-line. Heart and major vessels were segmented in a semi-automated manner (seeding, threshholding, and eventual manual editing) using Analyze (Mayo Clinic). The segmented data sets were then rendered and vizualised using vtk (Schroeder W, Martin K, Lorensen B. The Visualization Toolkit. 2nd ed. New Jersey: Prentice Hall, 1998).The adult patient had been diagnosed with pulmonary atresia and ventricular septal defect in childhood and had been managed conservatively. Nevertheless, he began to experience reduced exercise tolerance and became cyanotic. An MRA was requested to outline the source of his pulmonary blood supply. The MR angiograms (Figure 2) showed a large left pulmonary artery arising from the left side of the ascending aorta, with pruning of its distal branches. On the right side, the patient had a number of small pulmonary arteries that were not supplied by the aorta or its main branches. A double aortic arch was also discovered. The patient is being assessed for heart-lung transplantation. Download figureDownload PowerPointFigure 2. Maximum intensity projections of the adult patient MRA. A, Anterior view. B, Left anterior oblique view. A large left pulmonary artery arises just above the aortic valve with pruning of its distal vessels. There is a double aortic arch with both arches being widely patent into the descending aorta. Few small pulmonary vessels are present on the right side.The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.Circulation encourages readers to submit cardiovascular images to the Circulation Editorial Office, St Luke’s Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.FootnotesCorrespondence to Dr R. Razavi, Department of Paediatric Cardiology, Guy’s Hospital, Fifth Floor, London SE1 9RT, UK. E-mail: [email protected] Previous Back to top Next FiguresReferencesRelatedDetailsCited By Ladouceur M and Mousseaux E (2012) Scanner et imagerie par résonance magnétique des cardiopathies congénitales à l’âge adulte, EMC - Radiologie et imagerie médicale - Cardiovasculaire - Thoracique - Cervicale, 10.1016/S1879-8535(12)51902-1, 7:4, (1-25), Online publication date: 1-Nov-2012. Puranik R, Muthurangu V, Celermajer D and Taylor A (2010) Congenital Heart Disease and Multi-modality Imaging, Heart, Lung and Circulation, 10.1016/j.hlc.2010.01.001, 19:3, (133-144), Online publication date: 1-Mar-2010. Khositseth A, Siripornpitak S and Pornkul R (2010) Pulmonary atresia and ventricular septal defect with collaterals to right lung associated with anomalous left pulmonary artery from the ascending aorta, Pediatric Radiology, 10.1007/s00247-010-1832-2, 40:S1, (72-76), Online publication date: 1-Dec-2010. Helbing W and Moelker A (2010) MRI in Conotruncal Anomalies (Except Tetralogy of Fallot) Principles and Practice of Cardiac Magnetic Resonance in Congenital Heart Disease, 10.1002/9781444317039.ch9, (155-171) (2009) Anomalous pulmonary arteries Congenital Heart Defects, 10.1007/978-3-7985-1719-6_24, (173-175), . Layer G, Kauczor H, Morris E, Wintersperger B, Johnson T, Nikolaou K, Huber A, Bauner K, Michaely H, Schoenberg S, Fink C, Attenberger U, Michaely H, Schoenberg S, Theisen D, Kramer H and Schlemmer H Thorax and Vasculature Magnetic Resonance Tomography, 10.1007/978-3-540-29355-2_5, (663-861) Vecchione C, Aretini A, Marino G, Bettarini U, Poulet R, Maffei A, Sbroggiò M, Pastore L, Gentile M, Notte A, Iorio L, Hirsch E, Tarone G and Lembo G (2005) Selective Rac-1 Inhibition Protects From Diabetes-Induced Vascular Injury, Circulation Research, 98:2, (218-225), Online publication date: 3-Feb-2006. Franchini M, Veneri D, Salvagno G, Manzato F and Lippi G (2008) Inherited Thrombophilia, Critical Reviews in Clinical Laboratory Sciences, 10.1080/10408360600552678, 43:3, (249-290), Online publication date: 1-Jan-2006. Santos de Soto J and Maya Carrasco K (2005) Temas de actualidad en cardiología pediátrica y cardiopatías congénitas, Revista Española de Cardiología Suplementos, 10.1016/S1131-3587(05)74103-0, 5:1, (77A-89A), Online publication date: 1-Jan-2005. Muthurangu V, Razavi R, Bogaert J and Taylor A Congenital Heart Disease Clinical Cardiac MRI, 10.1007/3-540-26997-5_15, (439-473) Loomba R, Aiello S, Tretter J, Gaffar M, Reppucci J, Brock M, Spicer D and Anderson R (2020) Left Pulmonary Artery from the Ascending Aorta: A Case Report and Review of Published Cases, Journal of Cardiovascular Development and Disease, 10.3390/jcdd8010001, 8:1, (1) January 27, 2004Vol 109, Issue 3 Advertisement Article InformationMetrics https://doi.org/10.1161/01.CIR.0000113459.16277.D5PMID: 14744960 Originally publishedJanuary 27, 2004 PDF download Advertisement" @default.
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