CTICasesHypoplastic Left Heart Syndrome (Post-Norwood and Sano Shunt)
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Imaging findings
CT angiography demonstrates post-surgical changes of a Norwood procedure and Sano shunt in a patient with hypoplastic left heart syndrome. Findings include a small right ventricle, a hypoplastic left ventricle, a Sano shunt (conduit) connecting the right ventricle to the pulmonary artery, a reconstructed neoaorta, and a persistent, extremely tiny native ascending aorta that remains connected to the aortic root.
Key takeaways
In patients with hypoplastic left heart syndrome undergoing reconstructive surgery (such as the Norwood procedure with a Sano shunt), the tiny native ascending aorta is left intact. This native ascending aorta serves an essential physiological role by retrogradely perfusing the coronary arteries from the reconstructed neoaorta, preventing myocardial ischemia.
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