Author + information
- Received August 17, 2012
- Revision received September 2, 2012
- Accepted September 4, 2012
- Published online April 16, 2013.
A 9-year-old boy with previously diagnosed Tetralogy of Fallot was referred to our hospital for surgical evaluation. A physical examination revealed a grade 4/6 systolic ejection murmur over the left precordium and oxygen saturation of 95% (room air). Echocardiography demonstrated an anomalous origin of the left pulmonary artery (PA) arising from the ascending aorta (A, arrows, Online Video 1) and a 2-cm perimembranous ventricular septal defect (B, arrow, Online Video 2). Pulmonary angiography revealed the right PA arising from the main PA (C, *, Online Video 3), with absence of the left PA. Aortography revealed a right-sided aortic arch (D, arrowheads) and the left PA (D, *) arising from the ascending aorta (D, arrow, Online Video 4). Right pulmonary arterial pressure (89/46 mm Hg) and pulmonary vascular resistance (5 Wood units) were significantly reduced after a vasoreactivity test. The patient underwent successful surgical ventricular septal defect closure and reimplantation of the left PA to the main PA.
Hemitruncus arteriosus is rare. Pre-operative recognition of this anomaly is important for surgical planning. Asc Ao = ascending aorta; LA = left atrium; LPA = left pulmonary artery; LV = left ventricle; LVOT = left ventricular outflow tract; RA = right atrial; RV = right ventricle; RVOT = right ventricular outflow tract.
- Received August 17, 2012.
- Revision received September 2, 2012.
- Accepted September 4, 2012.
- American College of Cardiology Foundation