PMC5245853_01
Chest radiographs showing increased heart area, elongated left
ventricular and medial arches, and increased pulmonary vasculature
before (A) and two days after percutaneous closure (B). The medial
arch suggests the aorta arising from the left of the right
ventricle. The angiography shows the connection between the inferior
cava vein and right pulmonary artery with an extracardiac conduit by
fenestrated total cavopulmonary connection (arrow).
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The immediate recovery was satisfactory, with oxygen saturation greater than 90%, and a modest decrease in the cardiac area (Figure 1).
Cardiac angiography of pulmonary arterial tree showing the left
pulmonary artery (LPA) pulled upwards (A), the Blalock-Taussig
contrast medium in LPA (arrow) (B), and total occlusion of the
Blalock-Taussig shunt using the Amplatzer device (C). The
transesophageal echocardiography shows regurgitation of the right
atrioventricular valve (RAVV) to the right (D), its occlusion by the
Amplatzer device (E, F), and the wide left atrioventricular valve
(LAVV) opening (F). RA: right atrium, RPA: right pulmonary artery,
LPA: left pulmonary artery, LBT: left Blalock-Taussig, RAVV: right
atrioventricular valve, LAVV: left atrioventricular valve, rud RV:
rudimentar right ventricle, SLV: single left ventricle.
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Transesophageal echocardiography (Figure 2) showed situs solitus and levocardia, systemic venous drainage at total cavopulmonary connection. The right AV valve was closed using a 30-mm Amplatzer device and an Amplatzer duct occluder (ADO II, number 6) was used for the Blalock-Taussig shunt closure (Figure 2).