Direct communication between the right pulmonary artery and the left atrium

Surgical and Transcatheter Closure of Right Pulmonary Artery to Left Atrial Fistula

“…Later, Ohara and colleagues added a fourth type. 26 The three cases in our series all belong to type I. In 2007, Bockeria and associates proposed another classification method, based upon the anatomy of pulmonary venous drainage, the location of anomalous communication origin from the RPA, and the presence or absence of aneurysm on the communication.…”

“…22 When a patient presents with central cyanosis, clubbing of fingers, exertional dyspnea, silent precordium, normally split second heart sound, nonspecific murmur over the left or right axillary region, and an abnormal roentgenographic density in the right or left pulmonary hilum, this rare defect should be highly suspected. 1,[22][23][24][25] Though cardiac catheterization with selective angiography remains the most definitive means to confirm this anomaly and accurately describe the anatomical details, 1,22,26 color flow Doppler echocardiography is usually diagnostic, 27 and especially helpful in neonatal and prenatal patients. 6,9,13 According to de Souza e Silva and associates, 24 fistulas between the RPA and LA can be classified into three types, based upon the presence or absence of an aneurysm in the fistula and upon the anatomy of the pulmonary venous drainage pattern.…”

Fistula between the right pulmonary artery and the left atrium coexisting with a secundum‐type atrial septal defect: An unusual case of cyanosis in a girl

“…The fistulas between the PA and the LA generally classified into four types on the basis of the relationships between the fistulas and the PV. 8,10 In type I fistulas, the RPA branches are normal. RPA-to-LA fistulas considered as a rare cardiovascular anomaly.…”

Open heart surgery immediately after birth following prenatal diagnosis of a large right pulmonary artery to left atrium communication

“…According to de Souza e Silva et al (1974) RPA to LA communication can be classified into three anatomic types, based on the presence or absence of anomalies of the right lung, absence of right pulmonary veins, and differences in the anatomy of pulmonary venous drainage. A fourth type was later added by Ohara et al (1979). The case we present herein is type 1, with the abnormal communication entering the posterior wall of the LA and normal pulmonary venous connection.…”

“…Newborns with a large communication present with central cyanosis, decreased arterial oxygen saturation, tachypnea, and congestive heart failure resulting in neonatal death or requiring emergency cardiac surgery (Slack et al, 2000). Older children and adults usually present with cyanosis, clubbing, dyspnea d'effort, and polycythemia (de Souza e Silva et al, 1974;Ohara et al, 1979;Jimenez et al, 1989;Slack et al, 2000). Possible complications in these patients include endocarditis, cerebral abscesses, paradoxical emboli, aneurysmal growth of the fistula with the risk of fatal rupture, pulmonary hypertension, and congestive heart failure (Zeebregts et al, 1997;Mohanty et al, 2000).…”