PMC8424740_01
Coronal Computed tomography angiography thorax demonstrates absence of the left lung and pulmonary vessels. The LMB shows abrupt termination after the carina (thick black arrow). The mediastinum is completely displaced to the left side. There is associated fusion of the C2-C3 vertebrae (thin white arrow).
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CTA thorax (Figure 2) revealed reduced left hemithoracic volume, a hyperexpanded right lung and total mediastinal shift to the left. T4 level. The C2/C3 vertebral bodies were fused (Figure 2).
Computed tomography angiography thorax in the axial (A) and oblique coronal (B) planes reveals absence of the right lung, bronchus and pulmonary vessels with ipsilateral mediastinal shift. The left pulmonary artery (LPA) and veins (LPV) are present with a hyperinflated left lung. The trachea (T) divides into the left main bronchus (LMB) and communicates with the lower oesophagus (Oe) via a fistula (F) consistent with a tracheo-oesophageal fistula. The patent ductus arteriosus (PDA) is large. The tip of the central venous catheter (CVC) is in the right atrium (RA).
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CTA thorax (Figure 3) revealed total absence of the right lung, right main bronchus and right pulmonary vessels in keeping with pulmonary agenesis. The main pulmonary artery was 1.5 times larger than the ascending aorta suggestive of pulmonary hypertension (Figure 3).