RADIOLOGY: HEART: Case# 33677: RIGHT AORTIC ARCH, MITRAL AND PULMONIC VALVE PROSTHESIS SURGERY AND PRIOR BLALOCK-TAUSSIG SHUNT PLACEMENTACTIVE EXTRAVASATION FROM THE ASCENDING AORTA. S/P recent mitral and pulmonic valve prosthesis surgery and prior Blalock-Taussig shunt placement, currently presents with back pain and hypotension. 1. Findings consistent with active contrast extravasation from the anterior ascending aorta into the anterior mediastinum. 2. Right hemopneumothorax S/P right thoracotomy tube. 3. The right sided central venous line tip lies within the upper right pleural space. 4. Soft tissue density and air in the mediastinum are consistent with the patients recent surgery. 5. Status post pulmonic and mitral valve replacement. 6. No evidence for aortic dissection. 7. Right lower lobe consolidation consistent with pneumonia. 8. Cholelithiasis. 9. The findings were immediately discussed with the patients clinical team during the examination.