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Tetralogy of Fallot With Absent Left Pulmonary Artery in a Patient Who Passed Critical Congenital Heart Disease Screening



Case Reports

. 2022 Oct 23;14(10):e30604.


doi: 10.7759/cureus.30604.


eCollection 2022 Oct.

Affiliations

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Case Reports

Ruth Y Eletta et al.


Cureus.


.

Abstract

The literature on tetralogy of Fallot (TOF) is abundant. It is a fairly common cyanotic congenital heart disease. It results from the anterior malalignment of the conal septum resulting in the aberrant formation of the ventricular septum leading to a defect. This presents a very important clinical significance because the prognosis usually depends on the clinical evaluation and initiation of timely therapy. We present a two-week-old baby with normal birth history and an uncomplicated newborn nursery course. He also passed the Critical Congenital Heart Disease screen at 24 hours of life. The routine examination by the pediatrician led to further investigations and treatments, highlighting the importance of good history-taking and clinical examination skills.


Keywords:

absent left pulmonary artery; critical congenital heart disease; neonatal screening; pediatric congenital heart disease; tetralogy of fallot.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures



Figure 1. Echocardiogram Showing Blood Flow

AV= Aortic Valve; PV= Pulmonic Valve; VSD= Ventricular Septal Defect; LV= Left Ventricle; RV= Right Ventricle; RA= Right Atrium; Ao= Aorta; RPA= Right Pulmonary Artery; LPA= Left Pulmonary Artery; MPA= Middle Pulmonary Artery


Figure 2


Figure 2. Pre- and Post-Cardiac Catheterization Procedure

Intra-Operative Findings: Hypertrophied right ventricle with normal qualitative systolic function, Dynamic subvalvar pulmonary stenosis, Hypoplastic pulmonary valve annulus with a caliber of approximately 5.9mm, Hypoplastic main pulmonary artery with a caliber of 4.8mm, Confluent branch pulmonary arteries
Proximal right pulmonary artery caliber of 8.7mm, Proximal left pulmonary artery caliber of 2.4mm, with distal reference vessel caliber of 5.7mm. There was significant interval growth of distal artery vasculature

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