Two-dimensional echocardiographic identification of hemitruncus: anomalous origin of one pulmonary artery from ascending aorta with the other pulmonary artery arising normally from right ventricle

Abstract

Two-dimensional echocardiography (2DE) was performed on a 2300 gm newborn who presented with congestive heart failure. Clinical examination suggested left-to-right shunt with pulmonary hypertension. Cardiac catheterization and angiography demonstrated origin of the right pulmonary artery (RPA) from the aorta. Retrospectively, this feature (anomalous RPA) had been present on 2DE. A second patient aged 2 years had evidence of ventricular septal defect with large left-to-right shunt early in life. Gradual development of infundibular stenosis and clinical cyanosis ensued. 2DE showed subaortic ventricular septal defect with infundibular stenosis. Cardiac catheterization and angiography confirmed tetralogy of Fallot with origin of the left pulmonary artery (LPA) from the aorta. Retrospective review of 2DE showed the anomalous LPA arising from the side of the ascending aorta.