Surgical correction of absence of proximal segment of left pulmonary artery.

Abstract

In a 14-month-old patient who had been repeatedly hospitalized for recurrent pulmonary infections, cardiac angiography found "absence" of the left pulmonary artery, but thoracic aortography demonstrated that a rudimentary patent ductus filled a distal patent pulmonary artery. There was a coexistent vascular ring with a retroesophageal right subclavian artery. At surgical exploration it was possible to mobilize the distal left pulmonary artery and perform a direct anastomosis between the left pulmonary artery and the main pulmonary artery. This is perhaps the first patient in whom such an operation has been performed. It is emphasized that the absence of a pulmonary artery on pulmonary angiography does not indicate that the entire pulmonary artery is absent. The presence of a patent and surgically reconstructable distal pulmonary artery can be determined only by aortography or possibly by surgical exploration.