Anomalous origin of one pulmonary artery from aorta: Evaluation on computed tomography angiography

J Card Surg. 2022 Mar;37(3):483-491. doi: 10.1111/jocs.16229. Epub 2022 Jan 11.

Abstract

Aim: The present study sought to evaluate the morphology and associated cardiovascular anomalies in patients with anomalous origin of one pulmonary artery from aorta (AOPA) on CT angiography.

Materials and methods: A retrospective search of the departmental database from January 2014 to September 2021 was conducted to identify patients diagnosed with AOPA on CT angiography. The subtype of AOPA, site of origin, and associated cardiovascular abnormalities were assessed.

Results: AOPA was identified in 27 patients (19 males, mean age: 8.8 years). Anomalous origin of the right pulmonary artery from aorta (AORPA) was observed in 17/27 (63%) patients, while anomalous origin of the left pulmonary artery (AOLPA) was seen in 10/27 (37%) patients. The proximal and distal subtypes were observed in 24/27 (88.9%) and 3/27 (11.1%) patients respectively. AOPA was associated with other cardiac anomalies in 92.6% (25/27) patients. Patent arterial duct (11/17; 64.7%) was the most frequently anomaly associated with AORPA, while tetralogy of Fallot (10/10; 100%) was the most commonly anomaly associated with AOLPA. The anomalous pulmonary artery was contralateral to the aortic arch in 23/27 (85.2%) patients. Right-sided aortic arch was observed in only 2/17 (11.8%) patients with AORPA and 8/10 (80%) patients with AOLPA. In 2/10 (20%) patients, AORPA was associated with aortopulmonary window and aortic arch anomaly.

Conclusion: AOPA is rare and frequently associated with other cardiovascular anomalies like patent arterial duct, tetralogy of Fallot, and right-sided aortic arch. CT angiography helps in providing exact anatomical delineation and identifying associated anomalies, thus aiding preoperative planning of surgical management.

Keywords: anomalous origin of one pulmonary artery from aorta; computed tomography angiography; congenital heart disease.

MeSH terms

  • Aorta
  • Aorta, Thoracic / diagnostic imaging
  • Aortopulmonary Septal Defect*
  • Child
  • Computed Tomography Angiography*
  • Humans
  • Male
  • Pulmonary Artery / diagnostic imaging
  • Retrospective Studies