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. 2021 Jul 15;73:65. doi: 10.1186/s43044-021-00190-5

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© The Author(s) 2021

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 2 — (A and B) Transthoracic echocardiography depicts a significant gradient at the origin of the right pulmonary artery (A). Pulmonary computed tomography angiography reveals a significant stenosis at the origin of the right pulmonary artery (B). (C, D, E, F, and G) Selective right pulmonary artery injection shows significant stenosis in the upper and lower lobar branches (C). Kissing balloon dilation of both branches is done (D). Injection after balloon percutaneous angioplasty shows residual stenosis in both branches (E). Separate and simultaneous balloon percutaneous angioplasty procedures are performed on both branches using larger balloons (F). Final angiography shows mild residual stenosis in the lower branches with acceptable blood flow in the distal branches (G)