Images in cardiovascular medicine. Combined angiography and three-dimensional computed tomography for assessing systemic-to-pulmonary collaterals in pulmonary atresia with ventricular septal defect.

A12-month-old child was evaluated for pulmonary atresia with ventricular septal defect. Assessment of the whole arterial pulmonary arborization was first done by angiography. This examination revealed that the left lung received vascularization by the native pulmonary artery via a central shunt performed during the neonatal period and by 2 aortopulmonary collateral arteries. The positions of these 2 arteries and their spatial relationship with the left bronchus were clearly visualized before unifocalization by 3-dimensional CT.