Fig. 4

A 5-year-old boy with hypoplastic left heart syndrome (atresia of the mitral and aortic valves) and past medical history of several cardiac surgeries including Glenn procedure (multiplanar reformatted water-images in coronal view). Native and contrast-enhanced CMRA images demonstrate severely hypoplastic native ascending aorta that is connected to the brachiocephalic artery and shows distal trifurcation (arrow; note that the proximal coronary arteries are more clearly delineated on native images). Multiple small aorto-pulmonary collaterals with tortuous mediastinal course are visible (arrowheads). Susceptibility artifacts are present due to surgical stent material (asterisk). REACT relaxation-enhanced angiography without contrast