PMC5917864_01
Suprasternal short axis view with color Doppler interrogation showing mosaic flow in lower branch of right pulmonary artery (arrow) suggestive of stenosis. 1b: Continuous wave Doppler interrogation of lower branch of RPA showing velocity of 316 cm/sec (peak gradient of 40 mmHg with pandiastolic spilling) suggestive of severe stenosis of that branch.
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F1
Post balloon dilatation of lower branch of right pulmonary artery, color Doppler interrogation showing laminar flow (arrow) suggestive of normal pattern. 2b: Continuous wave Doppler interrogation of lower branch of RPA showing velocity of 122 cm/sec (peak gradient of 6 mmHg) suggestive of no stenosis
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F2
Post procedure echocardiography showed normalization of RV pressure (TR gradient 25 mmHg) with laminar flow in the right pulmonary artery branch (figure 2a,b).
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PMC5917864_04
Three Dimensional reconstruction of CT angiography of pulmonary veins showing: A. Severe stenosis of right superior pulmonary vein (RSV) and B. Severe stenosis of left inferior pulmonary vein (LIV).
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F3
There was severe, long segment stenosis of the left lower pulmonary vein with hypoplasia, along with severe stenosis of the right upper pulmonary vein (figure 3a, b).
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