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Aortic origin of right pulmonary artery: successful surgical correction in three consecutive patients
S A Nashef1, M P Jamieson, J C Pollock
1Department of Cardiac Surgery, Royal Hospital for Sick Children, Yorkhill, Glasgow, Scotland.
Insights
This study shows that aortic origin of the right pulmonary artery in infants is treatable with surgery. Early diagnosis via echocardiography and surgical correction lead to good long-term outcomes for this rare congenital heart defect.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Surgery
- Medical Imaging
Background:
- Aortic origin of the right pulmonary artery is a rare congenital heart anomaly.
- Associated conditions like persistent ductus arteriosus and right-sided aortic arch can occur.
- Accurate preoperative diagnosis is crucial for effective management.
Purpose of the Study:
- To report surgical outcomes for infants with aortic origin of the right pulmonary artery.
- To evaluate the diagnostic utility of echocardiography for this condition.
- To confirm the efficacy of surgical correction.
Main Methods:
- Retrospective review of 3 infant cases (1981-1984).
- Preoperative diagnosis using echocardiography.
- Anatomical surgical correction under cardiopulmonary bypass.
Main Results:
- No operative deaths occurred in the 3 infants.
- One infant required reoperation for anastomotic stenosis.
- All patients showed normal ventilation and perfusion post-surgery, with good long-term outcomes.
Conclusions:
- Aortic origin of the right pulmonary artery is a severe but surgically correctable congenital heart defect.
- Echocardiography is a reliable diagnostic tool for this anomaly.
- Surgical intervention leads to favorable long-term results.
Abstract:
Over a period of four years (1981 through 1984), 3 infants with aortic origin of the right pulmonary artery were seen in our surgical unit. Two infants had a persistent ductus arteriosus, which arose from the left subclavian artery in 1 of them who also had a right-sided aortic arch. There were no other associated abnormalities. Preoperative diagnosis was established by echocardiography in 2 infants. Anatomical surgical correction was undertaken in all 3 infants under cardiopulmonary bypass. There were no operative deaths. One child required reoperation at 15 months for anastomotic stenosis. All 3 children were well two to five years postoperatively with scintillographic evidence of normal ventilation and perfusion. Our experience indicates that this rare but severe congenital cardiac anomaly is easily diagnosed by echocardiography, and confirms that it is eminently amenable to surgical correction.