ABC | Volume 114, Nº4, Suplement, April 2020

Clinicoradiological Correlation Atik et al. Origin of right pulmonary artery from ascending aorta and pulmonary atresia in an adult Arq Bras Cardiol 2020; 114(4Suppl.1):43-46 chronic hypoxia induced biventricular dysfunction, in addition to other injuries responsible for the greatest ventricular hypertrophy, such as pulmonary atresia and even aortic dextroposition. There was clinical improvement after the performance of systemic-pulmonary anastomosis, which was a useful strategy for hypoxia mitigation. However, in face of the other parameters, a quicker deterioration is expected, with the emergence of thrombosis, embolism, arrhythmias, heart failure complications and even sudden events. On the other hand, the expectant conduct considered was the most plausible in view of the high and considerable surgical risk in Figure 2 – Angiotomography showing hypoplasia of the left pulmonary artery, with hypoplastic pulmonary artery continuity emerging from the right ventricle with minimum annular opening (A-D), and origin from dilated and hypertensive right pulmonary artery directly from the ascending aorta (E,F), Thinner inferior right lobe artery (F). RPA: right pulmonary artery; LPA: left pulmonary artery; IL-R: inferior right lobe. this age group, in addition to right-sided pulmonary arterial hypertension, and no adequate functional solution. 1 The question is, in similar cases in childhood, whether it would be more convenient to attempt an earlier correction. Undoubtedly, it should always be considered at different conditions to create an anatomic shape that is adequate and favorable to blood dynamics. 2 The combination of these defects is extremely rare since in the literature three similar cases are described, all of them involving the anomalous origin of the left pulmonary artery from the ascending aorta. 1-3 45