CORONARY ANGIOGRAPHY OF PULMONARY ATRESIA, HYPOPLASTIC RIGHT VENTRICLE, AND VENTRICULOCORONARY COMMUNICATIONS

A retrospective study was undertaken to determine the spectrum of angiographic abnormalities of the coronary arteries in infants and children with pulmonary atresia, hypoplastic right ventricle, and right ventriculocoronary arterial communications. Twenty-nine patients with 67 angiographic examinations were reviewed; findings in seven patients were compared with those at autopsy. Twenty-seven (93%) of 29 patients had caliber abnormalities of the involved coronary arteries, including obstructive lesions in 20 (69%) of 29 and segmental dilatation in 16 (55%) of 29. Nine patients had interruption of the anterior descending artery and one had absent connection between the coronary arteries and the aorta. A single coronary artery was found in four of 29 patients. There was excellent correlation between clinical angiography and autopsy findings in seven patients. This study confirms the ability of high-quality clinical angiography to show significant abnormalities of the coronary arteries in infants and children with pulmonary atresia and ventriculocoronary communications.