PMC8105093_01
(a) Chest radiograph after birth. (b) Chest computed tomography (CT) and (c) right ventricular angiography. The arrows show supravalvular pulmonary stenosis. (d) Pectus index value calculated using CT-based imaging.
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Immediately after birth, he was intubated in the operating room (Figure 1(a)) because of a lack of spontaneous respiration, and bilateral chest tubes were inserted. He was also diagnosed with supravalvular pulmonary stenosis (PS) with a pressure gradient of 40-45 mmHg (Figures 1(b) and 1(c)) between the right ventricle and pulmonary artery. Furthermore, he showed pectus carinatum diagnosed using CT-based pectus index of 1.90 (Figure 1(d)) (diagnostic range: 1.42-1.98).
Chest radiograph at discharge from the neonatal care unit.
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He was discharged on the 141st day of life from the neonatal care unit with some residual pleural effusion on the right (Figure 2).
(a) Chest radiograph on admission. (b) Contrast-enhanced CT on the 18th and (c) 55th day of admission. (d) Chest radiograph at discharge.
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Chest radiography revealed pleural effusions within the entire circumference of the right lung with prominent intestinal dilatation (Figure 3(a)). On the 18th day of hospitalization, the boy developed high fever, and contrast medium-enhanced computed tomography (CT) revealed a low-density lesion (3 cm in diameter) with a high-density capsule in the right inferior lobe (Figure 3(b)). CT and chest radiograph (Figures 3(c) and 3(d)), the patient was discharged from our department on the 59th day of hospitalisation. Cardiac catheterization to evaluate PS before discharge showed 7 mmHg of right atrial pressure (RAP), systolic right ventricular pressure (RVP)/end-diastolic pressure (EDP) of 90/10 mmHg, and main pulmonary arterial pressure (PAP) of 24/10 (mean 16).