Microangiography of the Pulmonary Arterial System in "Hypoplastic Left Heart Syndrome"

Microangiographic examination of the pulmonary arterial system in 12 newborn infants with concomitant stenosis or atresia of the aortic and mitral orifices showed that the intrapulmonary arterial pattern is influenced by the state of the foramen ovale. In infants with aortic atresia with a prematurely closed foramen ovale, that is cases in which the left side of the heart is a cul-de-sac, there is moderate or prominent tortuosity of the intralobular pulmonary arteries indicating congenital pulmonary hypertension. This feature is less prominent or absent in infants with valvular insufficiency of the foramen ovale, regardless of the postnatal age of the patient.