Anomalous origin of pulmonary branches from the ascending aorta. A report of five cases and review of the literature

Abstract The anomalous origin of pulmonary branches is a rare entity where, either the right or the left pulmonary arteries arise from the ascending aorta and where the aortic and pulmonary valves are separated. Clinical manifestations usually appear in the infant or, more rarely, in the newborn and include respiratory distress or congestive heart failure due to increased pulmonary resistance. The survival rate in an Indian series was 94% with the death of one patient from Fallot tetralogy. We have treated five patients with this congenital heart disease in 20 years; the survival rate was of 80% and in all survival cases, the systolic pressure was significantly decreased. The current treatment of choice, consisting of the anatomical correction with translocation of the right pulmonary artery to the pulmonary trunk, was first performed by Kirkpatrick in 1961. The aim of this paper is to show the Mexican experience in the diagnosis and treatment of the anomalous origin of pulmonary branches from the ascending aorta. Conclusion Early surgery with timely correction of this congenital heart disease improves the prognosis and survival rate of patients, with a reduction in pulmonary hypertension. Learning objective: This article reports a series of cases of anomalous origin of the pulmonary branches from the ascending aorta. This is a rare congenital anomaly of difficult clinical diagnosis that is often accompanied by other associated anomalies. The diagnosis is based on image studies such as computed tomography and echocardiography and the hemodynamic evaluation is essential to determine a surgical procedure. The surgical treatment consists of the anatomists of the pulmonary branch to the pulmonary trunk.>