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. 2015 Jul 11:10:97.
doi: 10.1186/s13019-015-0307-9.

Anomalous origin of the right pulmonary artery from the ascending aorta: results of direct implantation surgical repair in 6 infants

Li Xie  1 , Lei Gao  2 , Qin Wu  3 , Can Huang  4 , Jin-Fu Yang  5 , Tian-Li Zhao  6 , Zhong-Shi Wu  7 , Yi-Feng Yang  8
Affiliations

Anomalous origin of the right pulmonary artery from the ascending aorta: results of direct implantation surgical repair in 6 infants

Li Xie et al. J Cardiothorac Surg. .

Abstract

Background: Anomalous origin of the right pulmonary artery from the ascending aorta (AORPA) is a rare and potential fatal kind of congenital heart disease. This study summarizes the techniques and outcomes of 6 infants with AORPA who underwent the surgical repair.

Methods: Between November 2012 and November 2014, 6 infants with AORPA received surgical repair in the Second Xiangya Hospital and were included in the present study.

Results: Six infants (4 male, 66.7 %) with a median age of 101.5 ± 70.0 days, and a median body weight of 4.13 ± 0.62 kg underwent the surgical repair at our institute. There were no operative, in-hospital or follow-up deaths. Clinical symptoms of all 6 patients relieved at time of discharge, and mean pulmonary artery pressure (MPAP) decreased significantly after surgery. During follow-up, there were no further operations or interventions, mild stenosis at the anastomotic site presented in one patient, and all patients were asymptomatic and in stable clinical condition.

Conclusions: The short and mid-term surgical outcomes of AORPA are excellent in this group of operations. Moreover, we believe the direct implantation to be the optimal surgical strategy for the patients with the proximal form of AORPA.

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Figures

Fig 1
Fig 1
Preoperative CT angiography of Patient 2 identified the anomalous origin of the right pulmonary artery from the ascending aorta; a the antero-posterior VR. b the postero-anterior VR. AA: ascending aorta, LPA: left pulmonary artery, RPA: right pulmonary artery
Fig 2
Fig 2
Preoperative echocardiograghy of Patient 3 showed that the right pulmonary artery arose from the ascending aorta. LA: left atrium, LV: left ventricle, AAO: ascending aorta, RPA: right pulmonary artery, DAO: descending aorta
Fig 3
Fig 3
Operative view of Patient 2; a The right pulmonary artery (RPA) originated from the right posterior aspect of the ascending aorta. b The right pulmonary artery (RPA) was anastomosed to the main pulmonary artery (MPA) by direct implantation
Fig 4
Fig 4
Postoperative echocardiography of Patient 6
See this image and copyright information in PMC

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