Congenital Pulmonary Atresia with Ventricular Septal Defect: Angiographic and Surgical Correlates

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Abstract
Of 181 patients with severe congenital pulmonary atresia and ventricular septal defect or type IV truncus (an obsolete term), all but 11% had true central pulmonary arteries. These arteries were demonstrable by large serial biplane angiograms using multiple selective injections into collateral vessels, frequent photographic subtraction and occasional pulmonary vein-wedge angiograms. These techniques are extremely important for accurate diagnosis and in planning corrective or palliative surgery, which was done in 77% of patients with pulmonary arteries.

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