Case Of the Week (COW) 23 June 2013
Answer:
CONGENITAL AORTO PULMONARY WINDOW
Findings:
Cardiac MRI with Tru Fisp(White Blood) and Magnitude and Phase images are given. A communication is seen between the ascending aorta and the main pulmonary artery above the sinuses of Valsalva. It is seen in Phase images as high flow (white) between the Aorta and Main Pulmonary artery (relatively dark). The main Pulmonary artery is also significantly enlarged.
Discussion:
Aortopulmonary window is a rare congenital malformation resulting from abnormal septation of the truncus arteriosus into the aorta and the pulmonary artery. The defect is large and an important left-to-right shunt is present, resulting in congestive heart failure, pulmonary hypertension and early development of pulmonary vascular obstructive disease. In type I, the defect is situated between the ascending aorta and the main pulmonary artery just above the sinuses of Valsalva; In Type II, the defect is more distal, between the ascending aorta and the origin of the right pulmonary artery from the main pulmonary artery . type III consists of anomalous origin of the right pulmonary artery from the aorta.
Ref: European Journal of Cardio-thoracic Surgery 11 (1997) 293–297
Contributed By:
Dr. Sampath, Prof. Babu Peter
Barnard Institute of Radiology
Answer:
CONGENITAL AORTO PULMONARY WINDOW
Findings:
Cardiac MRI with Tru Fisp(White Blood) and Magnitude and Phase images are given. A communication is seen between the ascending aorta and the main pulmonary artery above the sinuses of Valsalva. It is seen in Phase images as high flow (white) between the Aorta and Main Pulmonary artery (relatively dark). The main Pulmonary artery is also significantly enlarged.
Discussion:
Aortopulmonary window is a rare congenital malformation resulting from abnormal septation of the truncus arteriosus into the aorta and the pulmonary artery. The defect is large and an important left-to-right shunt is present, resulting in congestive heart failure, pulmonary hypertension and early development of pulmonary vascular obstructive disease. In type I, the defect is situated between the ascending aorta and the main pulmonary artery just above the sinuses of Valsalva; In Type II, the defect is more distal, between the ascending aorta and the origin of the right pulmonary artery from the main pulmonary artery . type III consists of anomalous origin of the right pulmonary artery from the aorta.
Ref: European Journal of Cardio-thoracic Surgery 11 (1997) 293–297
Contributed By:
Dr. Sampath, Prof. Babu Peter
Barnard Institute of Radiology