Fig. 15
From: Looking beyond the thrombus: essentials of pulmonary artery imaging on CT
Illustration (a) demonstrates stage 1, the Norwood procedure, for correcting hypoplastic left heart syndrome with the creation of a neoaorta from the pulmonary artery. Post-repair images (b) have a characteristic appearance with a rudimentary proximal ascending aorta and the proximal main pulmonary artery (arrow) reconstituting flow to the distal ascending aorta (arrowhead). During the procedure, the pulmonary trunk is ligated and the pulmonary arterial flow is re-established from either the subclavian artery or the brachiocephalic trunk. After completion of stage 3 (c, d), by attaching the inferior vena cava to the right pulmonary artery, the Fontan procedure, complete systemic venous flow is directed through the right pulmonary artery into the lungs. Note the right pulmonary artery (arrow) shows higher attenuation secondary to the contrast injection from the right arm veins compared with the left pulmonary artery (arrowhead) which has lower attenuation due to blood flow from the inferior vena cava