[Anomalous origin of the right pulmonary artery: Non-invasive diagnosis and early surgery]

The anomalous origin of a branch of the pulmonary artery from the ascending aorta (AORPA) is a rare congenital heart disease accounting for approximately 0.12% of congenital heart defects, associated with high mortality rates, up to 70%, if not treated in a timely manner. The clinical spectrum ranges from asymptomatic presentation to pulmonary hypertension and heart failure in the neonatal period.

2-month-old breastfed infant with anomalous origin of the right pulmonary artery from the ascending aorta, initially suspected due to the presence of a cardiac murmur and a positive cardiac screening. Echocardiography and computed tomography angiography confirmed the diagnosis, showing no stenosis of the anomalous branch and no significant pulmonary hypertension as estimated by non-invasive methods. Surgical reimplantation was performed with anastomotic enlargement using bovine pericardium. The postoperative course was complicated by transient respiratory issues, with a favorable clinical outcome.

This case supports the usefulness of echocardiography and computed tomography angiography as tools for accurate anatomical diagnosis and based on each individual case for planning treatment. Furthermore, it reaffirms that, based on the specific anatomical characteristics of each case, direct reimplantation is not always the surgical technique of choice.