case_images: PMC11793089_01
case_images: Fetal echocardiography at 32+2 weeks of gestation showing the origin of the left pulmonary artery (LPA) in close proximity to the origin of the brachiocephalic trunk from the AoA.
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case_images: F1
case_images: Pulmonary arterial branch assessment showed that only the right branch PA arose from the main pulmonary artery (MPA), whereas the LPA appeared to arise from the AoA in close proximity to the origin of the brachiocephalic trunk (Fig. 1).
case_images: Fetal echocardiography. Pulsed-wave Doppler at 37+4 weeks of gestation showing a pulsatile pattern of the LPA usually seen in arteries.
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case_images: F2
case_images: Doppler imaging of both pulmonary arteries showed a normal flow pattern (shown in Fig. 2).
case_images: Scheme (a) of a cross-section of the upper thorax at the level of the three vessels and trachea with the corresponding color Doppler 3D image (b) at 30 weeks of gestation. In this view, both the transverse aortic arch (AoA) and the main pulmonary artery (MPA) show a course to the right of the trachea as a right arch. The MPA has a course under the AoA, gives origin to the right pulmonary artery (RPA), and connects via a right ductus arteriosus (right DA) into the descending aorta. Abnormal origin of the left pulmonary artery (LPA) is recognized as arising from the distal AoA via the left ductus arteriosus (left DA). L, left; R, right; SVC, superior vena cava.
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case_images: F3
case_images: Counseling with pediatric cardiologists raised the suspicion that the LPA may arise from a second left DA, which may have implications for the neonatal period (shown in Fig. 3).
case_images: Postnatal echocardiography. Continuous-wave Doppler tracing of stenotic left DA. LPA, left pulmonary artery; RPA, right pulmonary artery.
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case_images: F4
case_images: Fig. 4-6). Furthermore, the left-sided DA showed stenosis and restricted blood flow to the LPA.
case_images: Postnatal echocardiography. PA truncates with large RPA, pulmonary trunk, and non-confluent LPA. LPA, left pulmonary artery; RPA, right pulmonary artery.
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case_images: F5
case_images: Fig. 4-6). Furthermore, the left-sided DA showed stenosis and restricted blood flow to the LPA.
case_images: Postnatal echocardiography: origin of left DA from left truncus brachiocephalicus in right AoA. Tr. brachiocephalicus, truncus brachiocephalicus.
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case_images: F6
case_images: Fig. 4-6). Furthermore, the left-sided DA showed stenosis and restricted blood flow to the LPA.
case_images: a Schematic drawing of an AOLPA from a PDA Botalli in the presence of an RAA. Arrow, side of ductal constriction. b Schematic drawing of the postsurgical result of the reattached LPA to the MPA. Arrow, side of reattachment. RSA, right subclavian artery; CCA, common carotid artery; RAA, right-sided aortic arch; LSA, left subclavian artery; BA, brachiocephalic artery; PDA, persistent ductus arteriosus; RPA, right pulmonary artery; LPA, left pulmonary artery; MPA, main pulmonary artery; PV, pulmonary valve; AoV, aortic valve.
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case_images: F7
case_images: On day 5 postnatally, the newborn underwent surgical reimplantation and fixation of the LPA on the main trunk and resection of the ductal tissue by median sternotomy (shown in Fig. 7).