Surgical correction for one pulmonary artery arising from ascending aorta - report of five cases

Benatar, Abraham; Kinsley, Robin H.; Milner, S; Dansky, R; Hummel, David; Levin, Solomon E.

doi:10.1016/0167-5273(87)90148-3

Cited by 17 publications

(14 citation statements)

References 16 publications

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“…3,4,19,20 Kutsche et al 4 and Abu-Sulaiman et al 3 reported the largest series with anomalous origin of one pulmonary artery branch from the aorta, with 9 and 12 patients, respectively.…”

Section: Discussionmentioning

confidence: 97%

Anomalous origin of the left pulmonary artery from the aorta. Our experience and literature review

Prifti¹,

Bonacchi²,

Murzi³

et al. 2003

Heart and Vessels

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Three patients with anomalous origin of the left pulmonary artery (AOLPA) from the aorta underwent surgical correction. Two patients presented with an isolated malformation and one with an associated ventricular septal defect. One of the patients with an isolated malformation presented with an AOLPA from the descending thoracic aorta. Implantation of the AOLPA to the main PA trunk was performed by direct anastomosis in two patients and by interposition of a synthetic graft in the other patient with AOLPA from the descending aorta. All patients survived the operation. Low cardiac output was identified in one patient. The mean residual gradient through the anastomotic site was 21 mmHg at follow-up. We found almost 72 cases with AOLPA reported in the literature with a high mortality rate in patients not undergoing surgery. The most frequently found associated malformation is tetralogy of Fallot and ventricular septal defect. AOLPA from the aorta is a rare but important entity, necessitating a scrupulous preoperative and intraoperative evaluation. Patients with AOLPA can undergo surgical repair with excellent results.

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“…3,4,19,20 Kutsche et al 4 and Abu-Sulaiman et al 3 reported the largest series with anomalous origin of one pulmonary artery branch from the aorta, with 9 and 12 patients, respectively.…”

Section: Discussionmentioning

confidence: 97%

Anomalous origin of the left pulmonary artery from the aorta. Our experience and literature review

Prifti¹,

Bonacchi²,

Murzi³

et al. 2003

Heart and Vessels

View full text Add to dashboard Cite

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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%

“…18 The clinical presentation is that of a significant left-to-right shunt with early and rapidly progressive pulmonary hypertension, with or without right-sided heart failure. 3,14,19,20 The pulmonary vascular disease affects both lungs, and may be seen as early as three months of age. 20 The mechanism by which both lungs are affected involves neurogenic crossover from the involved lung to affect the protected lung, thereby producing reflex vasoconstriction in the protected lung.…”

Section: Discussionmentioning

confidence: 99%

“…20 The mechanism by which both lungs are affected involves neurogenic crossover from the involved lung to affect the protected lung, thereby producing reflex vasoconstriction in the protected lung. 3,7,20 Diastolic run-off due to shunting of blood away from the aorta into the aberrant pulmonary artery may affect coronary perfusion and result in left ventricular dysfunction. 14 The diagnosis of AOPA can be easily achieved by careful echocardiography.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

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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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Anomalous Origin of One Pulmonary Artery from the Aorta (Hemitruncus)

Hoffman

2009

The Natural and Unnatural History of Congenital Heart Disease

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Surgical correction for one pulmonary artery arising from ascending aorta - report of five cases

Cited by 17 publications

References 16 publications

Anomalous origin of the left pulmonary artery from the aorta. Our experience and literature review

Anomalous origin of the left pulmonary artery from the aorta. Our experience and literature review

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 One Pulmonary Artery from the Aorta (Hemitruncus)

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