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Figure 3d. Aortic coarctation in a 3-week-old girl with an atrioventricular septum defect (AVSD). Pulmonary vein anomalies were suspected at echocardiography. (a) Horizontal long-axis cine image shows the AVSD (**). LV = left ventricle, RV = right ventricle. (b–d) Posterior VR (b, c) and anterior subvolume MIP (d) MR angiographic images show a patent ductus arteriosus, a hypoplastic aortic arch, and the coarctation (arrow in b). The pulmonary vein anatomy is clearly defined as a common orifice of the left pulmonary veins—which is also stenotic (arrow in c)—and an anomalous connection of the right upper pulmonary vein (* in c and d) to the superior vena cava. AO = aorta, LPA = left pulmonary artery, RA = right atrium, RPA = right pulmonary artery. On the basis of the MR imaging findings, the coarctation was first repaired, and 3 weeks later, at the time of the AVSD repair, the left pulmonary veins were augmented and the right upper pulmonary vein was reimplanted into the left atrium.
