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Review
. 2021 Aug;36(8):2890-2900.
doi: 10.1111/jocs.15618. Epub 2021 May 28.

Anomalous right pulmonary artery from aorta, surgical approach case report and literature review

Khaled Alhawri  1   2 , Ali Alakhfash  1   2 , Abdullah Alqwaee  1 , Mohammed HassabElnabi  1 , Fazel Ahmed  1 , Mohammed Alhawri  3 , Bana Nasser  1 , Marwan Alhoobani  1 , Giusseppe Mazzesi  2 , Abdulraoof Alsaeedi  4 , Abdulrahman Almesned  1
Affiliations
Review

Anomalous right pulmonary artery from aorta, surgical approach case report and literature review

Khaled Alhawri et al. J Card Surg. 2021 Aug.

Abstract

Background: Anomalous origin of one pulmonary artery from the aorta is a rare congenital anomaly affecting the right pulmonary artery more than the left. These patients are at risk for the early development of significant pulmonary hypertension. Early surgical treatment has been proven safe with excellent results. The surgical approach and technique is challenging and should be decided ahead before the patient to surgery. Different techniques were described including direct reimplantation, conduit interposition, aortic ring flap.

Aim: We present a neonate with anomalous origin of the right pulmonary artery from the aorta and discuss the surgical technique and complications in the literature.

Keywords: anomalous pulmonary artery from aorta.

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Conflict of interest statement

The authors declare that there are no conflict of interests.

Figures

Figure 1
Figure 1
The preoperative echocardiogram. (A) Short‐axis parasternal view showing no continuity between the main pulmonary artery and the right pulmonary artery, (B) long‐axis parasternal view, (C) 5 chamber view, (D) suprasternal view all showing abnormal vessel coming out of the ascending aorta. Ao, aorta; AORPA, anomalous origin of right pulmonary artery from aorta; LA, left atrium; LV, left ventricle; PA, pulmonary artery
Figure 2
Figure 2
Operative view showing the anomalous origin of the right pulmonary artery from aorta. Ao, aorta; AORPA, anomalous origin of the right pulmonary artery from aorta; RA, right atrium; RV, right ventricle
Figure 3
Figure 3
Operative view showing the reconstucted anomalous right pulmonary artery connected to the main pulmonary artery. Ao, aorta; AORPA, anomalous origin of the right pulmonary artery from aorta; PA, pulmonary artery; RA, right atrium; RV, right ventricle
Figure 4
Figure 4
Anteroposterior cath view showing supra‐aortic stenosis at the site of anastomosis post repair
Figure 5
Figure 5
Direct implantation technique without and with patch augmentation of the aorta (inset 1), and patch augmentation of the right pulmonary artery (inset 2)
Figure 6
Figure 6
Conduit interposition of the anomalous right pulmonary artery using Dacron conduit graft
Figure 7
Figure 7
Use of aortic ring to elongate the RPA (single aortic flap technique)
Figure 8
Figure 8
Use of aortic flap to simultaneously repairing AORPA and aortopulmonary window. AORPA, anomalous origin of the right pulmonary artery from aorta
Figure 9
Figure 9
Double flap technique (ascending aortic and main pulmonary flaps), an anterior main pulmonary artery flap, and posterior aortic flap
Figure 10
Figure 10
Double flap technique (ascending aortic and main pulmonary flaps), a posterior main pulmonary artery flap, and anterior aortic flap
See this image and copyright information in PMC

References

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