title: Critical stenosis of a right ventricle to coronary artery fistula seen at dual-source CT in a newborn with pulmonary atresia and intact ventricular septum.
abstract: We report the case of a newborn with pulmonary atresia with intact ventricular septum and right ventricle-dependent coronary circulation. He died several weeks after a Blalock-Taussig procedure because of a progressive stenosis of the main coronary artery. We present echocardiographic and dual-source CT images of the stenosis, with autopsy correlation. To our knowledge, CT images of this quality have never been reported in a newborn. This case illustrates the extreme difficulty in prognosticating the outcome for these patients and underlines the need for a detailed neonatal coronary mapping to assess right ventricle-dependent coronary circulation.
authors.affiliation: Department of Pediatric Cardiology, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, France. peseguela@yahoo.fr
authors.forename: Pierre-Emmanuel
authors.initials: PE
authors.lastname: Séguéla
authors.forename: Lucile
authors.initials: L
authors.lastname: Houyel
authors.forename: Philippe
authors.initials: P
authors.lastname: Loget
authors.forename: Jean-Dominique
authors.initials: JD
authors.lastname: Piot
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Paul
mesh_terms: D058366:Blalock-Taussig Procedure; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000601:surgery; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000151:congenital / Q000000981:diagnostic imaging* / Q000601:surgery; D003326:Coronary Circulation; D017809:Fatal Outcome; D005402:Fistula / Q000150:complications / Q000151:congenital / Q000000981:diagnostic imaging*; D006330:Heart Defects, Congenital / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D006352:Heart Ventricles / Q000002:abnormalities / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D018633:Pulmonary Atresia / Q000150:complications*; D011856:Radiographic Image Enhancement / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods*; D054088:Ventricular Septum
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide