Gadolinium-enhanced magnetic resonance angiography of right ventricle to pulmonary artery shunts following Norwood 1 palliation in infants

The classic Norwood I palliation for the treatment of hypoplastic left-heart disease includes an atrial septectomy, neoaorta creation, and a systemic-to-pulmonary artery shunt. The Norwood I palliation has been modified by the use of a right ventricle-to-pulmonary artery shunt instead of a traditional systemic-to-pulmonary artery shunt. Right ventricle-to-pulmonary artery shunts were non-invasively imaged in four infants using gadolinium-enhanced magnetic resonance angiography. Diagnostic MR angiograms were performed in all infants throughout the length of the shunt and were useful in the detection of shunt patency, stenosis, and aneurysm. Associated surgical conduits and shunts were also evaluated. All findings were verified by subsequent conventional angiography or surgery.