An Alternative Non-Conduit Repair Strategy for Tetralogy of Fallot With Short Segment Pulmonary Atresia.

Tetralogy of Fallot (TOF) with pulmonary atresia is a subset in which it becomes imperative to use an artificial conduit in most cases. The atresia of the pulmonary artery can occur at various levels and be of variable lengths. For long segment pulmonary atresia, a right ventricle to pulmonary artery conduit is unavoidable in patients otherwise suitable for complete bi-ventricular repair with no major aortopulmonary collaterals, based on McGoon and Nakata indices. However, for patients with membranous pulmonary atresia and short segment atresia of the main pulmonary artery, we describe an alternative technique that avoids the use of handmade conduits or bovine jugular vein grafts and utilizes the concept of a monocusp with restoration of continuity from the right ventricular infundibulum to the distal main pulmonary artery. A seven-year-old girl diagnosed with TOF and pulmonary atresia underwent a right ventriculotomy with ventricular septal defect closure. The narrowed outflow tract was widened, and an anastomosis was made directly between the right ventricle and the pulmonary artery. A monocusp was fashioned from autologous pericardium, and the pulmonary artery was reconstructed using bovine pericardium. In TOF with pulmonary atresia, conventional surgery typically uses a valved conduit to connect the right ventricular outflow tract (RVOT) to the pulmonary artery. However, in cases like ours, direct anastomosis is possible due to a long confluent pulmonary segment. This alternative technique eliminates the need for an artificial conduit and may prevent associated problems. It also allows for potential growth of the neo-annulus and pulmonary segment. The risk of reoperation remains due to possible monocusp failure.

Society for Cardiovascular Magnetic Resonance 2022 Cases of SCMR case series.

"Cases of SCMR" is a case series on the SCMR website (https://www.scmr.org) for the purpose of education. The cases reflect the clinical presentation, and the use of cardiovascular magnetic resonance (CMR) in the diagnosis and management of cardiovascular disease. The 2022 digital collection of cases are presented in this manuscript.

A Starry Myocardium at CT: Cardiac Cysticercosis.

Supplemental material is available for this article.

"Dual" drainage in cardiac partial anomalous pulmonary venous return.

Anomalous drainage of pulmonary veins into the coronary sinus is an uncommon variety of anomalous pulmonary venous return. Rarely, anomalously draining pulmonary veins may show "dual" drainage. We present the imaging findings of an infant who had dual drainage of a cardiac type of partial anomalous pulmonary venous return in the setting of unroofing of the coronary sinus which has not previously been described.

Successful open surgical repair of large ilio-caval fistula presenting with congestive heart failure.

Ilio-caval arteriovenous fistula is a rare sequel of lumbar disc surgery or penetrating injury. We report a case of 40-year gentleman presenting with symptoms of congestive heart failure and continuous murmur heard over right iliac fossa. His past history was significant for lumbar disc surgery done twice 1 year back. Computed tomography angiogram confirmed a large fistulous communication between right common iliac artery and inferior vena cava. Open surgical repair was performed as the fistula was not well suited for endovascular repair. We successfully managed this case by open surgical ligation of right common iliac artery proximal and distal to fistula and continuity restored with interposition Dacron graft. He was relieved of symptoms and performing well on follow-up.

Isolated single coronary artery from nonadjacent sinus of Valsalva.

We present the computed tomography angiogram images of a 43-year-old lady with an isolated single coronary artery arising from the nonadjacent sinus of aortic root.

Transient versus surgically managed small bowel intussusception in children: Role of ultrasound.

BACKGROUND: To evaluate and compare the ultrasound (US) features of transient small bowel intussusception (SBI) with those which required surgical management. MATERIALS AND METHODS: US features of 26 children with 32 intussusceptions from January 2014 to August 2014 were recorded and compared with follow-up imaging or surgical findings. RESULTS: Transient SBI when compared to surgically managed intussusception has shorter length of intussusception (mean 2.25 cm, range 1.8-4.5 cm vs. mean 5.6 cm, range, 2.3-7.8 cm), smaller transverse diameter (mean, 1.2 cm, range 0.8-2.3 cm vs. mean, 3.3 cm, range 2.9-5.4 cm) and thin wall (mean, 3.3 mm, 2.3-4.9 mm vs. mean, 6.8 mm, range, 4.3-11.2 mm). Four out of five surgically managed intussusceptions were associated with the lead point while none of the transient SBI had any lead point. Peristalsis was absent in all surgically managed intussusceptions. CONCLUSION: Transient SBI is associated with a shorter length of intussusception, smaller transverse diameter, thin walls, absence of the lead point and visible peristalsis. All these findings may help in distinguishing it from those requiring surgical management.