[Anomalous origin of the right pulmonary artery from the ascending aorta: a report of eight cases].
We report eight cases with anomalous origin of the right pulmonary artery from ascending aorta. The ages at operation ranged from five days to fifteen years (average two years and seven months) with the body weights ranging from 1,610 g to 47.5 kg. Two patients underwent a surgical intervention in infancy; one of them with the body weight of 1,610 g was the smallest case previously reported in Japan. Associated cardiothoracic anomalies were patent ductus arteriosus (PDA) in five patients, atrial septal defect (ASD), PDA with ASD, tetralogy of Fallot with absent pulmonary valve in each one patient. Preoperative systolic pressure of pulmonary trunk were varied 83 to 115 mmHg (mean 94.7 mmHg). The continuity between pulmonary trunk and detached right central pulmonary artery was restored by a direct side-to-end anastomosis either behind (anatomical route) or in front of (non-anatomical route) the ascending aorta in all but one patient. There were one operative death and one hospital death. Postoperative pulmonary pressure was lower in patients with anatomical route than in patients with non-anatomical route. We conclude that successful surgical repair can be achieved by a direct anastomosis between abnormal detached central pulmonary artery and pulmonary trunk behind the ascending aorta even in infancy or early in childhood.
Nonoyama
M
M
Department of Pediatrics Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical College.
Imai
Y
Y
Sawatari
K
K
Nagatsu
M
M
D000293:Adolescent; D000714:Anastomosis, Surgical / Q000379:methods; D001011:Aorta / Q000002:abnormalities*; D001807:Blood Vessel Prosthesis; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011651:Pulmonary Artery / Q000002:abnormalities* / Q000601:surgery