Origin of the Right Pulmonary Artery from the Ascending Aorta

Armer, Robert M.; Shumacker, Harris B.; Klatte, Eugene C.

doi:10.1161/01.cir.24.3.662

Cited by 81 publications

(32 citation statements)

References 5 publications

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“…26 Due to the rapid development of irreversible pulmonary vascular disease in infancy and associated high mortality in the patients presenting with AOPA, re-implantation of the pulmonary artery is an operation that needs to be performed within the first year of life. 2,3,8,10,27 …”

Section: Discussionmentioning

confidence: 99%

Anomalous origin of the left pulmonary artery from the ascending aorta in two children with pulmonary atresia, subaortic ventricular septal defect and right-sided major aorto-pulmonary collateral arteries

Pepeta

Takawira

Cilliers

et al. 2011

CardioVascular Journal of Africa

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Anomalous origin of the left pulmonary artery from the ascending aorta in two children with pulmonary atresia, sub-aortic ventricular septal defect and right-sided major aorto-pulmonary collateral arteries L PEPETA, FF TAKAWIRA, PE ADAMS, NH NTSINJANA, BJ MITCHELL, AM CILLIERS AbstractWe report two rare cases of an anomalous origin of the left pulmonary artery (AOLPA) from the ascending aorta, associated with pulmonary atresia, a ventricular septal defect and a left aortic arch. The cases are unusual because AOLPA is more commonly associated with a right aortic arch and it is more usual for the right pulmonary artery to originate anomalously from the ascending aorta. The pulmonary blood supply to the right lung in both patients was absent and provided instead by major aorto-pulmonary collateral arteries which were stenosed at multiple levels. The AOLPA in both patients originated from the postero-lateral aspect of the ascending aorta just distal to the sino-tubular junction. Only one patient showed the more common association of an unusual aortic arch branching pattern in the form of an anomalous right subclavian artery.Neither patient was in heart failure and the chest X-ray in both revealed differential pulmonary perfusion with prominent vascularity of the left lung. Cardiac catheterisation showed systemic pressures within the anomalous left pulmonary artery. Karyotyping revealed normal chromosomes, and fluorescent in-situ hybridisation done in one patient was negative for chromosome 22q11.2 microdeletion. Both patients have been managed conservatively.Keywords: pulmonary atresia with ventricular septal defect, anomalous origin of pulmonary artery, collateral arteries, pulmonary hypertension, branchial arches, CATCH22 syndrome An anomalous origin of the pulmonary artery from the aorta (AOPA) is very rare, with the first case of this nature reported by Fraentzel in 1868. 1 The incidence of anomalous left pulmonary artery from the aorta (AOLPA) was reported in one study to be around 17%, 1 with anomalous origin of the right pulmonary artery (AORPA) from the ascending aorta as the more common variant of AOPA, seen in about 83% of cases. Without surgery, the mortality in patients with AOPA is extremely high, reaching as high as 80%. [2][3][4][5] This is due to severe, rapidly progressive pulmonary vascular disease and congestive cardiac failure. Both isolated AOLPA and that associated with other defects have been well described. 1,6,7 The commonest associated congenital cardiac lesion is tetralogy of Fallot, which is seen in about 75% of cases. 1 AOLPA is also associated with a right arch of the aorta in 63% of cases, and in about 38% of cases, an anomalous origin of the right subclavian artery from the descending aorta has been reported as well. 1 Of note, both our cases had a left aortic arch and had no main and right pulmonary arteries, with the only source of blood supply to the right lung being partially stenosed major aorto-pulmonary collateral arteries (MAPCAs).To the best of our knowledge, this series repr...

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Section: Discussionmentioning

confidence: 99%

Anomalous origin of the left pulmonary artery from the ascending aorta in two children with pulmonary atresia, subaortic ventricular septal defect and right-sided major aorto-pulmonary collateral arteries

Pepeta

Takawira

Cilliers

et al. 2011

CardioVascular Journal of Africa

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“…[4,5] Aorto-pulmonary window is frequently found as an isolated lesion, but can be associated with various other congenital cardiac anomalies. [6,7,8] The most common lesions associated with APW are the following: aortic origin of the right pulmonary artery, type I interruption of the aortic arch, anomalous origin of the right coronary artery from the pulmonary artery and Tetralogy of Fallot.…”

Section: Type III Defectsmentioning

confidence: 99%

Anomalous Location of Left Coronary Ostia With Aorto-Pulmonary Window: A Case Report

Ramakrishna¹,

Balureddy²,

Srivastava³

2016

jemds

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BACKGROUNDAorto-pulmonary window is a rare, but well-described congenital heart disease. The combination of Aorta Pulmonary Window (APW) with an anomalous origin of right coronary artery from pulmonary artery is extremely rare. But the association of anomalous location of left coronary ostia with aorto-pulmonary window is not yet reported till date. We report one such case, which was treated successfully.

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“…The first successful surgical correction was performed by Armer et al [7] in 1961 using a Dacron graft placed between the right pulmonary artery and the pulmonary trunk. Kirkpatrick et al [8] performed the first anatomical correction with translocation of the right pulmonary artery to the pulmonary trunk which is currently considered the treatment of choice.…”

Section: Introductionmentioning

confidence: 99%

Anomalous origin of pulmonary branches from the ascending aorta. A report of five cases and review of the literature

Mijangos-Vázquez

Chávez

Soto

et al. 2015

Journal of Cardiology Cases

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Origin of the Right Pulmonary Artery from the Ascending Aorta

Cited by 81 publications

References 5 publications

Anomalous origin of the left pulmonary artery from the ascending aorta in two children with pulmonary atresia, subaortic ventricular septal defect and right-sided major aorto-pulmonary collateral arteries

Anomalous origin of the left pulmonary artery from the ascending aorta in two children with pulmonary atresia, subaortic ventricular septal defect and right-sided major aorto-pulmonary collateral arteries

Anomalous Location of Left Coronary Ostia With Aorto-Pulmonary Window: A Case Report

Anomalous origin of pulmonary branches from the ascending aorta. A report of five cases and review of the literature

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