Direct communication between the right pulmonary artery and the left atrium: presenting with other congenital anomalies

Figure 1: Echocardiography showing, a large fistula with a diameter of 7 mm between the right pulmonary artery and the enlarged left atrium (A and B), CT scan showing an epidural hematoma (C). RA: right atrium; LA: left atrium; RPA: right pulmonary artery; AO: aorta; PA: pulmonary artery; RVOT: right ventricular outflow tract. Figure 2: Intraoperative view of the doubly ligated fistula between the right main pulmonary artery and the left atrium. SVC: superior vena cava; RPA: right pulmonary artery; LA: left atrium; AO: aorta.