Anomalous aortic origin of the pulmonary arteries: Case series and literature review

Salvatore Agati, Carlos Guerra Sousa, Felice Davide Calvaruso, Rosanna Zanai, Ivana Campanella, Daniela Poli, Alfredo Di Pino, Luca Borro, Fiore Salvatore Iorio, Massimiliano Raponi, Robert H Anderson, Simone Reali, Andrea De Zorzi, Aurelio Secinaro

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Abstract

Anomalous origin of the pulmonary arteries from the ascending aorta is a rare, but severe clinical entity necessitating a scrupulous evaluation. Either the right or the left pulmonary arteries can arise directly from the ascending aorta while the other pulmonary artery retains its origin from the right ventricular outflow tract. Such a finding can be isolated or can coexist with several congenital heart lesions. Direct intrapericardial aortic origin, however, must be distinguished with origin through a persistently patent arterial duct. In the current era, clinical manifestations usually become evident in the newborn rather than during infancy, as used to be the case. They include respiratory distress or congestive heart failure due to increased pulmonary flow and poor feeding. The rate of survival has now increased due to early diagnosis and prompt surgical repair, should now be expected to be at least 95%. We have treated four neonates with this lesion over the past 7 years, all of whom survived surgical repair. Right ventricular systolic pressure was significantly decreased at follow-up. Our choice of treatment was to translocate the anomalous pulmonary artery in end-to-side fashion to the pulmonary trunk. Our aim in this report is to update an Italian experience in the diagnosis and treatment of anomalous direct origin of one pulmonary artery from the aorta, adding considerations on the lessons learned from our most recent review of the salient literature.

Original languageEnglish
Pages (from-to)248-253
Number of pages6
JournalAnnals of Pediatric Cardiology
Volume12
Issue number3
DOIs
Publication statusPublished - Sep 14 2019

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Agati, S., Sousa, C. G., Calvaruso, F. D., Zanai, R., Campanella, I., Poli, D., Di Pino, A., Borro, L., Iorio, F. S., Raponi, M., Anderson, R. H., Reali, S., De Zorzi, A., & Secinaro, A. (2019). Anomalous aortic origin of the pulmonary arteries: Case series and literature review. Annals of Pediatric Cardiology, 12(3), 248-253. https://doi.org/10.4103/apc.APC_89_18