We describe a rare case of left pulmonary artery (LPA) originating from a closed left patent ductus arteriosus (PDA). A neonate underwent left PDA reopening and stenting. Reperfusion injury was minimized while allowing time for interval growth of the distal LPA. At four months of age, surgical reconstruction was performed to reconnect the LPA to the main pulmonary artery (MPA) with an anterior MPA flap augmented with pericardial patch. Autograft reconstruction is preferred to accommodate patients’ growth. Postoperative angiogram showed confluent flow into LPA and distal pulmonary branches. Patient was discharged without complications and was well after 1 year.
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