Post balloon pulmonary valvotomy x-ray chest PA view

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Post balloon pulmonary valvotomy x-ray chest PA view showing the persistent dilatation of main pulmonary artery (MPA) and left pulmonary artery (LPA) (see the annotated image below). The right pulmonary artery (RPA) is not dilated. This is because the jet of pulmonary stenosis is directed towards the left pulmonary artery from the main pulmonary artery, which is more in line with it. There is only mild residual pulmonary stenosis on Doppler echocardiography. Usually the left pulmonary artery shadow is within the cardiac silhouette and is not easily visible like this. Here the cardiac size is small so that the left pulmonary artery is visible outside the cardiac silhouette.

Post balloon pulmonary valvotomy x-ray chest PA view - annotated