CTICasesCTEPH with Systemic-to-Pulmonary Venous Collaterals
Imaging findings
CT angiography in a patient with chronic thromboembolic pulmonary hypertension (CTEPH) shows eccentric vascular webs and bands, vessel caliber discrepancies, and an extensive network of dilated mediastinal systemic venous collaterals communicating with the left atrium.
Key takeaways
In the setting of severe CTEPH and elevated right heart pressures, pre-existing systemic-to-pulmonary venous pathways can dilate and open. This collateral vascular network acts as a right-to-left shunt, contributing to systemic desaturation and complicating surgical planning.
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