Right pulmonary artery arising from ascending aorta: report of a successfully treated case

A nine-day-old neonate presented with signs of congestive heart failure during the first week of life. The echocardiogram showed an early bifurcating great vessel originating from the left ventricle. In addition, there was another vessel originating from the right ventricle directly connected to the descending aorta without early branching into the bilateral pulmonary arteries. A muscular ventricular septal defect (VSD) was also found. Cardiac catheterization and angiography showed that: 1) the anomalous origin of the right pulmonary artery arose from the ascending aorta; 2) a large patent ductus arteriosus (PDA) connected the main pulmonary artery and the descending aorta; and 3) a muscular VSD existed. Magnetic resonance imaging also demonstrated the above findings. Reimplantation of the anomalous right pulmonary artery to the main pulmonary artery and ligation of the PDA were done. To the best of our knowledge, this very unusual case is the first such neonatal case with successful surgical repair in Taiwan.