Repair of Anomalous Aortic Origin of Pulmonary Artery: Technique Matters

Abstract

The anomalous aortic origin of a pulmonary artery (PA) is uncommon, usually occurring on the right. Less commonly, the left PA is involved, often with a right-sided arch. Although referred to by some as “hemitruncus,” two semilunar valves are present. 1 Jacobs M.L. Congenital heart surgery nomenclature and database project: truncus arteriosus. Ann Thorac Surg. 2000; 69: S50-S55 Abstract Full Text Full Text PDF PubMed Google Scholar Because the right lung is exposed to systemic pressures, and the left receives the entire (and increased) cardiac output, there is high risk for developing pulmonary vascular disease (PVD). Typically, patients present with heart failure in infancy and undergo repair on diagnosis. The crux of the repair is translocation of the anomalous vessel to the main PA using various techniques. 2 Prifti E. Bonacchi M. Vanini V. Bartolozzi F. Double-flap technique for repair of anomalous origin of right pulmonary artery from ascending aorta. Ann Thorac Surg. 2004; 78: 1883-1884 Abstract Full Text Full Text PDF PubMed Scopus (7) Google Scholar Whereas all report excellent short-term outcomes, varied rates of postoperative PA stenosis have been demonstrated. 3 Nathan M. Rimmer D. Piercey G. et al. Early repair of hemitruncus: excellent early and late outcomes. J Thorac Cardiovasc Surg. 2007; 133: 1329-1335 Abstract Full Text Full Text PDF PubMed Scopus (47) Google Scholar Outcomes of Surgical Reimplantation for Anomalous Origin of One Pulmonary Artery From the AortaThe Annals of Thoracic SurgeryVol. 111Issue 4PreviewAnomalous origin of one pulmonary artery from the ascending aorta (AOPA) is a rare and potentially deadly anomaly. Little research, aside from case reports on APOA, has been published, especially for patients with late referrals. Full-Text PDF