Hemitruncus Arteriosus: Cardiac Magnetic Resonance Angiography Findings

Abstract

Hemitruncus arteriosus (HA) is an uncommon congenital cardiac malformation in which one pulmonary artery branch originates from the ascending aorta. A 2-month-old male was referred to our hospital for failure to thrive, cyanosis, and tachypnea. A chest radiograph demonstrated moderate cardiomegaly and peribronchial thickening. Echocardiography demonstrated right atrial and ventricular enlargement and increased gradient (25 mm Hg) in the right pulmonary artery. Cardiac magnetic resonance angiography was performed and clearly revealed typical imaging findings of a right HA which had complex cardiac and vascular anatomy. This case report presents cardiac magnetic resonance angiography findings of HA.

Anomalous Origin of One Pulmonary Artery From the Ascending Aorta

“…The anomalous origin of one pulmonary artery from the ascending aorta is a rare but potentially devastating CHD, requiring immediate surgical correction to avoid progressive pulmonary hypertension and congestive heart failure. [4][5][6][7][8][9][10][11] Anomalous origin of the right pulmonary artery is much more common than a left one as demonstrated in our cohort and confirmed by others. [13][14][15][16][17] Transthoracic echocardiography is a very important diagnostic tool used to evaluate this entity, with an accuracy of almost 90% as well as for the diagnosis of associated anomalies.…”

“…These techniques reveal additional anatomic details, such as the proximal segment of the left pulmonary artery, which is a frequent blind spot for transthoracic echocardiography. 7 All our patients underwent chest X-ray, transthoracic echocardiography, and cardiac computed tomography as exemplified in Figure 1. In the present series, the diagnosis of anomalous origin of the right pulmonary artery was correctly done by transthoracic echocardiography in 100% of cases.…”

“…3 Since the first description, no more than 250 cases have been reported in the literature with a high mortality among patients not surgically treated. 2,[4][5][6][7][8][9] The anomalous origin of the right pulmonary artery is much more common than the left one. 2 Patients with this anomaly present with congestive heart failure and early onset of pulmonary hypertension usually in the first year of life.…”

“…2,4,6 The diagnosis can be established using one or more of several imaging modalities: transthoracic echocardiography, cardiac computed tomography, conventional angiography, and in recent years magnetic resonance angiography (MRA). 7 Since the first successful anatomic repair of the anomalous origin of the right pulmonary artery using a polyester fiber graft by Armer et al, in 1961, 10 different techniques have been developed to reimplant the anomalous pulmonary artery to the main pulmonary artery with homologous tissue. 2,11 In Africa, there is only one report regarding two cases, both treated conservatively.…”

Clinical and anatomopathological descriptions of dog with arterious Hemitruncus: case report

“…The absence of this septation in the embryological trunk, through the infundibulum's trunk ridges, generates a single artery that arises from the base of the heart, supplying the systemic, pulmonary and coronary blood flows (Schwarzwald et al, 2003;Nicolle et al, 2005). It is considered an unusual cardiac malformation in humans (Nathan et al, 2007;Urbina-Vazquez et al, 2020), corresponding to 0.1% of all congenital cardiovascular anomalies (Koplay et al, 2012). In domestic animals, it is rare, being described in the scientific literature in cat (Nicolle et al, 2005;Chuzel et al, 2007), calf (Schwarzwald et al, 2003) and dog (Scollan et al, 2011).…”