We report a direct main pulmonary artery (MPA) to left atrium (LA) communication in a 21-month-old infant which is closed by transcatheter approach using a muscular VSD occluder. We explain the characteristic diagnostic clues of this anomaly on chest radiography, echocardiography and angiography. To our knowledge this is the first case of congenital MPA to LA communication effectively occluded by a VSD muscular occluder.
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