CTICasesComplex Congenital Heart Disease Post-Fontan
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Imaging findings
A 22-year-old male with previous cardiac repair presented with pulmonary atresia and an intact septum. CT demonstrated coronary sinusoids within the right ventricle and a total cavopulmonary (Fontan) shunt. Additionally, systemic-to-pulmonary collaterals were identified, which provided a right-to-left shunt, while the coronary sinusoids functioned as a left-to-right shunt.
Key takeaways
In complex congenital heart disease with Fontan circulation, systemic-to-pulmonary collaterals can provide right-to-left shunting, bypassing the pulmonary circulation to reach the left atrium. Understanding these shunting dynamics is critical in the evaluation of post-surgical congenital cardiac patients.
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