Results: 35 patients with PA-VSD were diagnosed and operated (24 patients) by the HCM city heart institute, University medical center, Children's hospital 1 and 2. Our results: pulmonary trunk: 76% present, 24% absent; 58% severe hypoplasia; right pulmonary artery and left pulmonary artery: 80% confluence, 20% no confluence, the size varies: 52% - 59% normal, 27% - 29% severe hypoplasia, 6% - 9% absent; Patent ductus arteriosus: 54% present, 46% absent; pulmonary collaterals: 77% present, 94% arising from descending thoracic aorta, 10% having stenosis.