Cardiac Computed Tomography Evaluation of Tetralogy of Fallot with Absent Pulmonary Valve Spectrum and Aneurysmal Pulmonary Artery Dilatation Causing Airway Compression

Abstract

Tetralogy of Fallot (TOF) with absent pulmonary valve (APV) spectrum is a rare congenital cardiac anomaly characterized by dysplastic or APV leaflets, leading to severe pulmonary regurgitation and aneurysmal dilatation of the pulmonary arteries. We report a 4-year-old male presenting with recurrent respiratory infections. Cardiac computed tomography (CT) revealed TOF with a subaortic ventricular septal defect, overriding aorta, right ventricular hypertrophy, and right ventricular outflow tract narrowing. The pulmonary valve was dysplastic, with marked aneurysmal dilatation of the main and branch pulmonary arteries, causing compression of the right main bronchus. This case highlights the role of cardiac CT in comprehensive anatomical assessment and its importance in preoperative planning.