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Non-confluent pulmonary arteries in a patient with pulmonary atresia and intact ventricular septum: ? a 5th aortic arch with a systemic-to-pulmonary arterial connection

Published online by Cambridge University Press:  19 August 2008

Astolfo Serra Jr
Affiliation:
Department of Pediatric Cardiology, Instituto Estadual de Cardiologia Aloysio de Castro, Rio de Janeiro Brasil and CARPE-Cardiologia Pediatrica e Fetal- Rio de JaneiroBrasil
Francisco Chamie
Affiliation:
Division of Pediatric Cardiology, Department of Cardiology, Hospital dos Servidores do Estado-MS, Rio de Janeiro Brasil, and CARPE-Cardiologia Pediatrica e Fetal- Rio de JaneiroBrasil
R.M. Freedom*
Affiliation:
Division of Cardiology, Department of Pediatrics, the Hospital for Sick Children, Toronto and University of Toronto Faculty of Medicine, Toronto, Canada
*
Robert M. Freedom, MD, FRCPC, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, CanadaM5G 1X8. Tel: 1–416–8136132; Fax: 1–416–8137547, E-mail: rfreedom@sickkids.on.ca

Abstract

Major abnormalities of pulmonary circulation are uncommon in the patient with pulmonary atresia and intact ventricular septum. Non-confluent pulmonary arteries have only rarely been described in this setting. In this case report, we describe a patient in whom the pulmonary arteries are non-confluent, with the right pulmonary artery supplied through a right-sided arterial duct, and the left pulmonary artery most likely through a fifth aortic arch, thus providing a systemic-to-pulmonary arterial connection. We discuss the various forms of non-confluent pulmonary arteries in the setting of pulmonary atresia and intact ventricular septum.

Type
Brief Reports
Copyright
Copyright © Cambridge University Press 2000

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References

1.Freedom, RM, Mawson, J, Yoo, S-J, Benson, LN. Congenital Heart Disease. Textbook of Angiocardiography. Futura Publishing Co., Armonk, NY, 1997;617662Google Scholar
2.Van Praagh, R, Ando, M, Van Praagh, S, Senno, A, Hougen, TJ, Novak, G, Hastreiter, AR. Pulmonary atresia: anatomic considerations. In, The Child with Congenital Heart Disease after Surgery. Eds Kidd, BSL and Rowe, RD. Futura Publishing Co., Inc., Mt Kisco, NY, 1976;103134Google Scholar
3.Milanesi, O, Daliento, L, Thiene, G. Solitary aorta with bilateral ductal origin of non-confluent pulmonary arteries in pulmonary atresia with intact ventricular septum. Int J Cardiol 1990;29: 9092.CrossRefGoogle ScholarPubMed
4.Luciani, GB, Swilley, S, Starnes, VA. Pulmonary atresia, intact ventricular septum, and major aortopulmonary collaterals: morphogenetic and surgical implications. J Thorac Cardiovasc Surg 1995;110: 853854.CrossRefGoogle ScholarPubMed
5.Mildner, RJ, Kiraly, L, Sreeram, N. Pulmonary atresia, “intact ventricular septum”, and aortopulmonary collateral arteries. Heart 1997;77: 173175CrossRefGoogle Scholar
6.Gerlis, LM; Ho, SY; Anderson, RH; Da Costa P Persistent 5th aortic arch-a great pretender: three new covert cases. Int J Cardiol 1989;23: 239247CrossRefGoogle ScholarPubMed
7.Freedom, RM; Silver, M; Miyamura, H. Tricuspid and pulmonary atresia with coarctation of the aorta: a rare combination possibly explained by persistence of the fifth aortic arch with a systemic-to-pulmonary arterial connection. Int J Cardiol 1989;24: 241245CrossRefGoogle ScholarPubMed
8.Yoo, SJ; Moes, CA; Burrows, PE; Molossi, S; Freedom, RM. Pulmonary blood supply by a branch from the distal ascending aorta in pulmonary atresia with ventricular septal defect: differential diagnosis of fifth aortic arch. Pediatr Cardiol 1993,14: 230233CrossRefGoogle ScholarPubMed
9.Donofrio, MT, Ramaciotti, C, Weinberg, PM, Murphy, JD. Aortic atresia with interruption of the aortic arch and an aortopulmonary fistulous tract: Case report. Pediatr Cardiol 1995;16: 147149.CrossRefGoogle Scholar