Help identifying structures on CT

[mtu620]

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Hello,

Want some help identifying the following structures as I've been staring at these images for way too long. Some background: this pt has right sided aortic arch, multiple redo-sternotomies for truncus arteriosus for RV-PA conduit replacements. Below are the official reads. Could you help me identify the "new communication" b/t the pseudoaneurysm and the pulmonary artery conduit in series 2 image 135? Can you help me identify the pseudoaneurysms in series 2 image 113 and series 2 image 109?

There is interval increase in size of contrast outpouching arising from
the upper most portion of the left posterior coronary sinus
pseudoaneurysm, extending superiorly and to the left with new
communication with the pulmonary artery conduit and mixing of contrast
at this region (series 2 image 135).

Slightly more prominent contrast outpouching from the anterior right
coronary sinus (series 2 image 113) measuring 21 x 8 mm, previously 16 x
7 mm and another contrast outpouching from the left posterior coronary
sinus (series 2 image 109) measures 41 x 20 mm, previously 38 x 20 mm.
These are compatible with pseudoaneurysms.

Thanks

 

[Radology]

This sounds and looks like an incredibly complicated case that cannot be deciphered with 3 selected images, without priors and clinical history

 

[Cognovi]

The history is here: Case

Be sure to give a shoutout to radiology in your presentation.

 

[Gurby]

Be sure to give a shoutout to radiology in your presentation.

Too bad AI is gonna make you guys obsolete in 5 years /s

 

[Cognovi]

Too bad AI is gonna make you guys obsolete in 5 years /s

Man, Al gets the most shoutouts already (specifically, some gunner named Et Al).