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Figure 8 Results of a Bidirectional Cavopulmonary Anastomosis in a 14-Month-Old Boy With Right Isomerism

Contrast-enhanced angiograms show an unobstructed surgical anastomosis as well as the pulmonary arteries and veins. The right pulmonary artery (RPA) and vein are smaller than the vessels on the left side. The numbers in the figures represent flow volumes in liters per minute. There is net reversed flow in the left pulmonary artery (LPA). The amount of the systemic arterial collateral blood flow to each lung can be calculated by subtracting the pulmonary arterial blood flow volume from the pulmonary venous return. The right and left lungs receive systemic arterial collateral arterial flow of 0.2 and 0.6 l/min, respectively. Subsequent X-ray angiography confirmed florid systemic collateral circulation to the left lung and subtle collateral circulation to the right lung. SVC = superior vena cava. Reproduced with permission from Yoo et al. (30).