Fig. 14

Select axial CT images in the bone (A and C), soft tissue (B), and lung windows (D). A Large perimembranous VSD (red asterisk) and right ventricular hypertrophy. B Dilated pulmonary trunk (blue asterisk) C reflux of contrast into the IVC and hepatic veins D bilateral pulmonary parenchymal mosaicism. Findings are compatible with pulmonary hypertension and right ventricular heart strain due to a long-standing VSD. Although this is an example of an isolated VSD, similar features of pulmonary hypertension can be seen in large residual VSDs in the setting of repaired TOF or repaired D-TGA with a VSD