Echocardiography Diagnosis And Prognosis Of The Anomalous Origin Of One Pulmonary Artery From The Ascending Aorta

ObjectiveTo evaluate the early diagnosis and prognosis of the anomalous origin of one pulmonary artery (AOPA) from the ascending aorta.Methods12 patients with AOPA in Children’s Hospital of Chongqing Medical University were analyzed retrospectively.ResultsAll of 12 patients had the anomalous origin of the right pulmonary artery (AORPA) from the ascending aorta. In addition, other cardiac malformations were found in all the patients and the most common one was PDA (8/12,66.67%). The accuracy of echocardiography in diagnosis of AOPA was 83.33%.11 patients were with pulmonary arterial hypertension (PAH)(11/12,92.67%) before operation, and mean pulmonary artery pressure (MPAP) was (79.45±14.36) mmHg. MPAP had descended to (35.91±16.26) mmHg one week after operation. There was significant difference between pre-operation and post-operation for the MPAP (Z=2.936, P= 0.003).Among 9 severe PAH cases pre-operation,5 cases became normal,1 case had mild PAH and 3 cases were moderate PAH after operation. Among 2 patients with moderate PAH pre-operation,1 patient became normal and the other one had mild PAH post-operation. Only one patient with tetralogy of Fallot (TOF) had no PAH.8 patients who were followed up ranging from 1 to 50 months had normal pulmonary artery pressure (PAP) monitoring by echocardiography. There were no reoperation cases during the follow-up period.ConclusionEchocardiography may replace the invasive cardiovascular angiography in the diagnosis of AOPA from ascending aorta with multi-layers CT, which will be confirmed by more evidences. The prognosis of AOPA from ascending aorta will be better if treated earlier. The PAP and the anastomotic stenosis are the key points in the longtime follow-up.