Single Origin of Right and Left Pulmonary Artery Branches from Ascending Aorta with Nonbranching Main Pulmonary Artery: Relevance to a New Understanding of Truncus Arteriosus

Abstract Objective: This study is designed to explore the dual-source computed tomography (DSCT) imaging manifestations of the origin of three rare pulmonary artery abnormalities, and to improve the understanding and diagnosis of the disease.Methods: Collected 30 cases of patients diagnosed by DSCT with pulmonary artery abnormal origins, and retrospectively analyzed their imaging data and postoperative pathological data.Results: Among the 30 patients with abnormal pulmonary artery origin, 16 patients were with unilateral pulmonary artery absence (UAPA), 8 patients were with anomalous origin of unilateral pulmonary artery (AOPA), and 6 patients were left pulmonary artery suspension (LPAS). The diagnosis rate of DSCT is significantly higher than that of echocardiography. The results of DSCT imaging showed that the inner diameter of the ascending aorta, the aortic arch and the descending aorta of UAPA patients were significantly larger than those of LPAS patients (P<0.05). Compared with AOPA patients, the left pulmonary artery diameter, the ratio of the left main pulmonary artery diameter to the main pulmonary artery diameter, and ratio of the left main pulmonary artery diameter to the right main pulmonary artery diameter were significantly increased in UAPA patients (P<0.05). There was no significant difference in the ratio of the inner diameter of the ascending aorta to the descending aorta in patients with UAPA, AOPA and LPAS. Compared with UAPA patients, AOPA patients had no significant changes in the inner diameter of the main pulmonary artery, the inner diameter of the right main pulmonary artery, and the ratio of the inner diameter of the right main pulmonary artery to the main pulmonary artery.Conclusion: DSCT can be used to diagnose the origin of pulmonary artery abnormalities and distinguish its types.

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Single origin of right and left pulmonary arteries from ascending aorta with atretic main pulmonary artery from right ventricle and left pulmonary sling

Journal of Cardiovascular Computed Tomography ◽

10.1016/j.jcct.2015.06.002 ◽

2015 ◽

Vol 9 (6) ◽

pp. 599-600 ◽

Cited By ~ 1

Author(s):

Min-Ling Hsieh ◽

Li-Ting Huang ◽

Jieh-Neng Wang ◽

Yi-Shan Tsai

Keyword(s):

Pulmonary Artery ◽

Right Ventricle ◽

Main Pulmonary Artery ◽

Pulmonary Arteries ◽

Ascending Aorta ◽

Single Origin ◽

Pulmonary Sling

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Anomalous Origin of Left Pulmonary Artery From Ascending Aorta: Embryological Model

10.22541/au.163439267.79149923/v1 ◽

2021 ◽

Author(s):

Bin Li ◽

Aijun Liu ◽

Ming Yang ◽

Junwu Su

Keyword(s):

Pulmonary Artery ◽

Congenital Heart ◽

Left Subclavian Artery ◽

Ductus Arteriosus ◽

Main Pulmonary Artery ◽

Left Pulmonary Artery ◽

Ascending Aorta ◽

Anomalous Origin ◽

Left Wall ◽

Heart Malformation

Background Anomalous origin of the left pulmonary artery (ALPA) from the ascending aorta (AA) is a rare congenital heart malformation. Aim To give some of our embryological considerations of ALPA from the AA. Methods We present a patient with ALPA from the AA, right-sided aortic arch, right-sided ductus arteriosus (DA), and aberrant left subclavian artery (LSCA). Results The distal end of ALPA was cut off, the proximal end was sutured, and the distal end was directly anastomosed to the left wall of the main pulmonary artery (MPA). Conclusion The failure of migration and differentiation of cardiac neural crest cells at the fourth and sixth archs result in unilateral arch agenesis or failure of detachment of the left sixth arch from the aortic sac, which form ALPA the AA.

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PULMONARY ARTERY AND AORTIC DIAMETERS;

The Professional Medical Journal ◽

10.29309/tpmj/2017.24.10.716 ◽

2017 ◽

Vol 24 (10) ◽

pp. 1476-1479

Author(s):

Faran Nasrullah ◽

Rashid Mahmood ◽

Shahlisa Hameedi

Keyword(s):

Pulmonary Artery ◽

Pediatric Population ◽

Main Pulmonary Artery ◽

Average Diameter ◽

Left Pulmonary Artery ◽

Ascending Aorta ◽

Military Hospital ◽

Radiology Department ◽

Healthy Children ◽

Descending Aorta

Objectives: To measure pulmonary artery and aortic calibers, and calculatingmain pulmonary artery to ascending aorta ratio in healthy children, to verify the adult ratio of1:1. Study Design: Observational study. Place and duration of study: Radiology Department,Combined Military Hospital, Peshawar from 15 July 2015 to 14 July 2016. Methodology:Chest CT cans of 283 healthy children, with no history or predisposing causes of pulmonaryhypertension, performed between July 2015 and July 2016, were retrospectively studied.Diameters of pulmonary artery and aorta were measured on CT chest, at the level of bifurcationof the main pulmonary artery, and the ratio of pulmonary artery to ascending aorta wascalculated. Results: The average diameter of the main pulmonary artery, right pulmonary arteryand left pulmonary artery were 19 mm, 12.1 mm and 12.2 mm respectively. The diameter of theascending aorta was determined to be 12.2 mm and descending aorta was 13.67 mm. Ratio ofthe main pulmonary artery to ascending aorta was 1.06, which was higher than the adult ration,usually taken as <0.9. Conclusion: The measurement criteria devised for early detection ofpulmonary hypertension have different set of values when considering pediatric population ascompared to adults. Main pulmonary artery to ascending aorta ratio is significantly higher inhealthy children of all ages as compared to adults. CT scan is an excellent minimally invasivemodality in evaluation of the mediastinal vasculature.

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Repair of Anomalous Pulmonary Artery with Interposition Graft: Midterm Results

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849230501300305 ◽

2005 ◽

Vol 13 (3) ◽

pp. 217-221 ◽

Cited By ~ 1

Author(s):

Eli Levy ◽

Eli Milgalter ◽

Amiram Nir ◽

Azaria JJT Rein

Keyword(s):

Pulmonary Artery ◽

Main Pulmonary Artery ◽

Left Pulmonary Artery ◽

Ascending Aorta ◽

Midterm Results ◽

Interposition Graft ◽

Right Pulmonary Artery ◽

Anomalous Pulmonary Artery ◽

Echocardiographic Findings

Anomalous pulmonary artery arising from the aorta is a rare congenital anomaly. The midterm results of repair of this malformation by Gore-Tex graft interposition were examined in 5 patients: 3 with anomalous right pulmonary artery and 2 with anomalous left pulmonary artery from the ascending aorta. Echocardiography was adequate in 4 cases for diagnosis, planning the operation, and follow-up. Angiography was needed for diagnosis in one case where the echocardiographic findings were unclear. The mean follow-up period was 4 years. One patient with tracheoesophageal fistula and cardiac malformation died 2 months after the operation due to multi-organ failure. Three patients needed re-operation because of graft narrowing, and one was without problems 5.2 years postoperatively. In anomalous pulmonary artery from the ascending aorta, repair should be performed as early as possible to prevent pulmonary hypertensive changes. When the anomalous pulmonary artery cannot be anastomosed directly to the main pulmonary artery, an interposition graft can be placed safely without cardiopulmonary bypass. With appropriate follow-up, this can be a satisfactory solution, although it carries the risk of re-operation due to graft narrowing.

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Gastric wall fat falo sign as a risk factor for cardiovascular diseases

10.22541/au.160806868.80102350/v1 ◽

2020 ◽

Author(s):

Ali Kupeli ◽

Ethem Unver ◽

Gurkan Danisan ◽

Eser Bulut

Keyword(s):

Pulmonary Artery ◽

Gastric Wall ◽

Main Pulmonary Artery ◽

Pulmonary Arteries ◽

Left Pulmonary Artery ◽

Ascending Aorta ◽

Control Group ◽

Descending Aorta ◽

Cardiothoracic Ratio ◽

Halo Sign

A B S T R A C T Objective: To investigate the relationship between gastric wall fat halo sign and potentially associated cardiovascular disease (CVD) in thoracic computed tomography (CT). Material and Methods: Between October 2018 and June 2019, 62 patients with gastric wall fat halo sign and 97 controls were prospectively evaluated. Patient height, weight, body mass index (BMI), sex, age, ascending aorta, descending aorta, main pulmonary artery, right and left pulmonary artery, long and short cardiac axis and maximum transverse thorax diameters; and ascending, arcus, descending aorta and coronary artery calcium scores were recorded for the two groups. Results: No significant differences were found in sex, age, height, body weight or BMI between the two groups (p > 0.125). Patients with gastric wall fat halo sign had significantly larger diameters of the ascending aorta, the descending aorta, the main pulmonary artery, the right and left pulmonary arteries, and the short and long cardiac axes and a higher cardiothoracic ratio (CTR) than the control group (p < 0.001). Additionally, the calcium scores of the ascending, arcus, and descending aortas and the coronary arteries were significantly higher detected in patients group (p < 0.001). Conclusion: The gastric wall fat halo is the result of excessive fat accumulation and can be observed in overweight people, especially those with increased visceral fat tissue. Additionally, patients with a gastric wall fat halo have a higher cardiovascular risk because of increased vascular diameters, CTR, heart sizes and calcium scores.

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Single origin of right and left pulmonary arteries from ascending aorta, with main pulmonary artery from right ventricle.

Heart ◽

10.1136/hrt.43.3.363 ◽

1980 ◽

Vol 43 (3) ◽

pp. 363-365 ◽

Cited By ~ 11

Author(s):

A Beitzke ◽

E A Shinebourne

Keyword(s):

Pulmonary Artery ◽

Right Ventricle ◽

Main Pulmonary Artery ◽

Pulmonary Arteries ◽

Ascending Aorta ◽

Single Origin

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Pulmonary atresia with a ventricular septal defect and left pulmonary artery discontinuity: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-02750-4 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Hyun-Hwa Cha ◽

Hae Min Kim ◽

Won Joon Seong

Keyword(s):

Pulmonary Artery ◽

Subclavian Artery ◽

Septal Defect ◽

Left Subclavian Artery ◽

Ductus Arteriosus ◽

Main Pulmonary Artery ◽

Pulmonary Arteries ◽

Pulmonary Atresia ◽

Left Pulmonary Artery ◽

Right Pulmonary Artery

Abstract Background Unilateral pulmonary artery discontinuity is a rare malformation that is associated with other intracardiac abnormalities. Cases accompanied by other cardiac abnormalities are often missed on prenatal echocardiography. The prenatal diagnosis of isolated unilateral pulmonary artery discontinuity can also be delayed. However, undiagnosed this malformation would have an effect on further prognosis. We report our case of a prenatal diagnosis of pulmonary atresia with ventricular septal defect and left pulmonary artery discontinuity. Case presentation A 33-year-old Asian woman visited our institution at 24 weeks of gestation because of suspected fetal congenital heart disease. Fetal echocardiography revealed a small atretic main pulmonary artery giving rise to the right pulmonary artery without bifurcation and the left pulmonary artery arising from the ductus arteriosus originating from the left subclavian artery. The neonate was delivered by cesarean section at 376/7 weeks of gestation. Postnatal echocardiography and multidetector computed tomography showed a right aortic arch, with the small right pulmonary artery originating from the atretic main pulmonary artery and the left pulmonary artery originating from the left subclavian artery. Patency of the ductus arteriosus from the left subclavian artery was maintained with prostaglandin E1. Right ventricular outflow tract reconstruction and pulmonary angioplasty with Gore-Tex graft patch was performed 25th day after birth. Unfortunately, the neonate died because of right heart failure 8 days postoperation. Conclusion There is a possibility that both pulmonary arteries do not arise from the same great artery (main pulmonary artery or common arterial trunk). Therefore, clinicians should check the origin of both pulmonary arteries.

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