1Department of Thoracic and Cardiovascular Surgery, Sapporo Medical College, 2Department of Pediatrics, Sapporo Medical College
Origin of the right pulmonary artery from the ascending aorta, Two-dimensional echocardiography, Pulsed Doppler echocardiography
wo-dimensional echocardiography was performed in a case where the right pulmonary artery originated from the ascending aorta. The abnormal echo with a tubular structure was found by echocardiography. Echocardiogram revealed that this tubular structure continued to the ascending aorta and was connected to it at the right posterior position. This abnormal echo was recognized as an echo of the right pulmonary artery by angiography, retrospectively. Surgical correction was carried out by anastomosis of the right pulmonary artery to the main pulmonary artery by use of a graft which was placed over the aorta. Postoperative echocardiogram showed the disappearance of the abnormal echo. The graft echo was present over the ascending aorta. The blood flow was studied by Doppler echocardiography. It disclosed the turbulent flow of the blood stream from the main pulmonary artery to the right pulmonary artery through the graft. This was confirmed
by digital subtraction angiography. The diagnosis of this disease using two-dimensional echocardiography can be started by visualizing the abnormal echo with a tubular structure which continued to the ascending aorta. The Doppler echocardiography may be useful as a noninvasive technique to verify whether the graft is patent or not, postoperatively.