Anomalous origin of both pulmonary arteries from the ascending aorta with a nonbranching main pulmonary artery arising from the right ventricle

Abstract

A 3-month-old boy, mildly cyanosed and tachypneic, was found by cineangiography to have a nonbranching main pulmonary artery arising from the right ventricle and connecting to the descending aorta via a large persistent ductus arteriosus. The left and right pulmonary arteries arose as a common "trunk," before branching, from the ascending aorta. Complete surgical correction was performed at 7-months of age. Subsequent cardiac catheterization has demonstrated normal pressures and blood oxygen saturation in all right-heart chambers and the great arteries.

The bronchopulmonary foregut malformation complex

“…In this particular child, neither the right nor the left pulmonary arteries originated from the ascending aorta, as has been observed in most of the reported cases in which the pulmonary trunk itself is non-bifurcating. [140][141][142][143] Rather, the only source of arterial supply to the lungs in our patient was from persistent intersegmental arteries, exactly reminiscent of the direct systemicto-pulmonary collateral arteries seen in many patients with tetralogy of Fallot and pulmonary atresia. 7 In the bigger group of patients with such systemic supply to otherwise normal lungs, it is unclear why there is the predilection for the left lower lobe, yet a similar predilection is observed in patients with extralobar sequestration.…”