Anomalous origin of right pulmonary artery from innominate artery: Repair using pulmonary artery pedicled flap plasty

Abstract

Origin of the right pulmonary artery from innominate artery is an exceedingly rare anomaly. We report two cases with this anomaly that underwent surgical repair. The surgical technique described achieves tissue-to-tissue anastomosis using a pedicled flap from the main pulmonary artery.

Rehabilitation of pulmonary arteries: hybrid treatment in the unilateral absence of the pulmonary artery.

“…3 Due to its presentation at different ages and with different stages of pulmonary hypertension, it is important to determine the appropriate therapeutic approach, without a consensus on its management. Thereby, Batlivala et al 7 highlight the importance of an early diagnosis and intervention to optimize long-term results, recommending the initial diagnosis with cardiac catheterization or magnetic resonance imaging to adequately identify the anatomy and perform pulmonary unifocalization early, coinciding with Varghese et al 8 that recognition of the anatomy is essential since it proposes reconnection in patients with origin of RPA from the brachiocephalic trunk with a flap from the MPA. Krammoh et al 5 propose a two-stage strategy, with the placement of an intraductal stent followed by direct surgical reconnection or a prosthetic graft, coinciding with the series by Mery et al, 9 where they performed centralization, a surgical connection between the MPA and RPA, in a single stage in 2 patients.…”

Rehabilitation of pulmonary arteries: Hybrid treatment in the unilateral absence of the pulmonary artery

“…3 Due to its presentation at different ages and with different stages of pulmonary hypertension, it is important to determine the appropriate therapeutic approach, without a consensus on its management. Thereby, Batlivala et al 7 highlight the importance of an early diagnosis and intervention to optimize long-term results, recommending the initial diagnosis with cardiac catheterization or magnetic resonance imaging to adequately identify the anatomy and perform pulmonary unifocalization early, coinciding with Varghese et al 8 that recognition of the anatomy is essential since it proposes reconnection in patients with the origin of RPA from the brachiocephalic trunk with a flap from the PT. Krammoh et al 5 propose a two-stage strategy, with the placement of an intraductal stent followed by direct surgical reconnection or a prosthetic graft, coinciding with the series by Mery et al, 9 where they performed centralization, a surgical connection between the PT and RPA, in a single stage in two patients.…”

Autologous Reconstruction of Anomalous Origin of a Right Pulmonary Artery From the Aorta

“…10 Varghese et al have reported creating a posteriorly based transverse pedicled flap from the anterior wall of the MPA that was augmented anteriorly by a pericardial patch; thus, completing the formation of a horizontal tube. 11 In 2006, a large series involving 16 patients from Children's Hospital Boston over a period of more than two decades was reported. 12 In 13 patients, direct implantation of the AOPA was performed into the side of the MPA.…”

“…10 Varghese et al have reported creating a posteriorly based transverse pedicled flap from the anterior wall of the MPA that was augmented anteriorly by a pericardial patch; thus, completing the formation of a horizontal tube. 11…”

“…2 Multiple methods for repair have been described. [3][4][5][6][7][8][9][10][11][12][13][14] In this report, we describe an alternative technique with its advantages.…”