[Abnormal origin of the right pulmonary artery from the ascending aorta. Echocardiographic diagnosis apropos of 2 cases] (original) (raw)
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Archivos de cardiología de México
Objective: The aim of this report is to describe a clinical case of an anomalous origin of the left pulmonary artery branch from the ascending aorta, and to present a current literature review of this rare disease. Clinical case: A 2 year-old infant was referred to our institution for surgical correction of sub aortic obstruction. The non invasive investigation disclosed a right aortic arch anatomy with left ventricle outflow tract obstruction due to sub aortic membrane associated but failed to show the anomalous origin of the left pulmonary artery branch from the ascending aorta. The diagnosis was made intraoperatively and the patient underwent a total surgical correction of the defects, including simultaneous anastomosis of the left pulmonary artery to the pulmonary trunk. Results of the surgical repair of this case were successful. Conclusions. Although anomalous origin of the left pulmonary artery from the ascending aorta is a rare disease which was not diagnosed appropriately, ...
Anomalous Origin of the Right Pulmonary Artery From the Ascending Aorta in a 10-Month-Old Child
Journal of Investigative Medicine High Impact Case Reports, 2016
Anomalous origin of the right pulmonary artery from the ascending aorta is a rare congenital deformity associated with poor quality of life and reduced life expectancy. Without a corrective surgery, less than one third of cases will live to see their sixth month. We report a case of a 10-month-old male child from Tanzania who presented with a 6-month history of recurrent respiratory tract infections, mild effort intolerance, and failure to thrive.
Cardiology in the Young, 2010
Introduction: Anomalous origin of one pulmonary artery from the ascending aorta is a rare cardiac anomaly in which the pulmonary artery abnormally arises from the ascending aorta. Physiologically, most patients develop signs of cardiac failure due to high flow to both lungs, with systemic or supra-systemic pressures in the normally connected lung. The purpose of this study is to present our experience with this rare anomaly, in which early anatomic repair lead to rapid physiologic correction. Materials and methods: Retrospective case review of all patients with anomalous origin of one pulmonary artery from the ascending aorta at Schneider Chidren's Medical center of Israel between 1986 and 2007. All clinical operative and echocardiographic charts were analysed. Results: Twelve patients were diagnosed as anomalous origin of one pulmonary artery from the ascending aorta. In 10 patients, the right pulmonary artery rose from the ascending aorta, while in two an anomalous origin of the left pulmonary artery was associated with a right aortic arch. Initial diagnoses was made with two-dimensional echocardiography in all patients. In six patients, diagnostic cardiac catheterisation was performed in order to confirm the diagnosis. Age at diagnosis ranged from 5 to 180 days with a median of 15 days, and patient weight ranged from 780 grams to 5 kilograms, with a median of 3 kilograms. Initial echocardiographic evaluation showed systemic (four patients) or supra-systemic (seven patients) pressures in the right ventricle and normally connected lung. All underwent surgical repair. There was no operatrive mortality. All reconstructed patients achieved normal right ventricular pressures within days after surgery. The flow pattern in both pulmonary arteries was normalised. Conclusions: Early surgical repair of anomalous origin of one pulmonary artery from the ascending aorta is feasible and safe even in newborn and premature babies with complete resolution of the pulmonary hypertension and normalisation of pulmonary vascular resistance.
Anomalous origin of the left pulmonary artery from the aorta. Our experience and literature review
Heart and Vessels, 2003
Three patients with anomalous origin of the left pulmonary artery (AOLPA) from the aorta underwent surgical correction. Two patients presented with an isolated malformation and one with an associated ventricular septal defect. One of the patients with an isolated malformation presented with an AOLPA from the descending thoracic aorta. Implantation of the AOLPA to the main PA trunk was performed by direct anatomosis in two patients and by interposition of a synthetic graft in the other patient with AOLPA from the descending aorta. All patients survived the operation. Low cardiac output was identified in one patient. The mean residual gradient through the anastomotic site was 21 mmHg at follow-up. We found almost 72 cases with AOLPA reported in the literature with a high mortality rate in patients not undergoing surgery. The most frequently found associated malformation is tetralogy of Fallot and ventricular septal defect. AOLPA from the aorta is a rare but important entity, necessitating a scrupulous preoperative and intraoperative evaluation. Patients with AOLPA can undergo surgical repair with excellent results.
Italian heart journal : official journal of the Italian Federation of Cardiology, 2004
We report a case of an anomalous origin of the right pulmonary artery (RPA) from the ascending aorta diagnosed at echocardiography at 13 days of age. The diagnostic clue was relieved in the suprasternal and parasternal high short-axis views, showing aorto-RPA continuity with a systolic flow in the left pulmonary artery and a systo-diastolic flow in the RPA. At 34 days of age the infant was submitted to surgery during which a direct end-to-lateral anastomosis without conduit interposition was performed. During the short-term follow-up the patient developed RPA stenosis at the anastomosis site and underwent percutaneous stent implantation.
The Annals of Thoracic Surgery, 2005
A 1-month-old patient was brought to our institution with clinical signs of pulmonary hypertension. Cross-sectional echocardiography suggested a diagnosis of aortopulmonary window. At the time of surgery, we found that the right pulmonary artery was arising anomalously from the left side of the ascending aorta, but was also connected to the pulmonary trunk by a fibrous cord. We reimplanted the right pulmonary artery into the pulmonary trunk, closing the resultant opening in the ascending aorta by direct suture. The postoperative course was uneventful. On follow-up, the patient is asymptomatic without medication.
Heart, 1986
A two day old neonate presented with cyanosis. The echocardiogram was misinterpreted as showing transposition of the great arteries. Cardiac catheterisation was performed the next day and showed anomalous origin of the right pulmonary artery from the aorta. Surgical correction at the age of 4 days was successful. At the age of nine months the patient was symptom free with "normal" cardiac anatomy. This patient is the youngest case to have successful correction of this anomaly. The initial misinterpretation of the echocardiogram could have had serious consequences if balloon atrial septostomy had been attempted.