A communication between the right pulmonary artery (RPA) and the left atrium is a rare congenital anomaly that presents with cyanosis and heart failure. We describe the surgical repair of an RPA to left atrial fistula using cardiopulmonary bypass in a neonate. Advanced imaging (computed tomography scan) guided the surgical approach. Although previous reports have associated a patent ductus arteriosus with high neonatal mortality, in our case, the ductus arteriosus was actually important for maintaining enough total pulmonary blood flow.
ZeebregtsCJNijveldALamJvan OortAMLacquetLK. Surgical treatment of a fistula between the right pulmonary artery and left atrium: presentation of two cases and review of literature. Eur J Cardiothor Surg. 1997;11(6):1056–1061.
2.
JimenezMFournierAChoussatA. Pulmoanry artery to the left atrium fistula as an unusual cause of cyanosis in the newborn. Pediatr Cardiol. 1989;10(4):216–220.
3.
FriedlichABingRJBlountSGJr. Physiological studies in congenital heart disease; circulatory dynamics in the anomalies of venous return to the heart including pulmonary arteriovenous fistula. Bull Johns Hopkins Hosp. 1950;86(1):20–57.
4.
LuoGHMaWGHuangLJYanJZhuXD. Surgical and transcatheter closure of right pulmonary artery to left atrial fistula. J Card Surg. 2011;26(2):130–134.
5.
ClarkeCPGohTHBlackwoodAVenablesAW. Massive pulmonary arteriovenous fistula in the newborn. Br Heart J. 1976;38(10):1092–1095.
SassolasFLongJLBozioA. Right pulmonary artery-left atrium communication : a rare cause of refractory hypoxia in newborn infants [in French]. Pediatrie. 1984;39(3):203–208.
8.
SlackMCJedeikenRJonesJS. Transcatheter coil closure of a right pulmonary artery-to-left atrial fistula in an ill neonate. Catheter Cardiovasc Interv. 2000;50(3):330–333.
9.
DiazGMarquezAGentileJ. Right pulmonary artery to left atrial fistula: a description of two cases, emphasizing a diagnostic approach. Cardiol Young. 2012;22(3):279–284.
10.
AkhtarMJRosengartRMSalemMM. Transcatheter closure of a giant communication between the right pulmonary artery and left atrium in a neonate. Catheter Cardiovasc Interv. 2013;82(1):159–162. doi:10.1002/ccd.24887.
11.
CheathamJPBarnhartDAGutgesellHP. Right pulmonary artery to left atrium communication: an unusual cause of cyanosis in the newborn. Pediatr Cardiol. 1982;2(2):149–152.
12.
ArendrupH. Direct communication between the pulmonary artery and left atrium. Scand J Thorac Cardiovasc Surg. 1982;16(2):157–160.
13.
KumarSMSivansankaranS. Right pulmonary artery-to-left atrial fistula: a rare cause of neonatal cyanosis. Pediatr Cardiol. 2013;34(3):757–759.
14.
BurkampAGhislaRKnirschWKretschmarOBalmerC. Catheter interventional closure of a large right pulmonary artery-to-left atrial communication in a neonate. Pediatr Cardiol. 2012;33(8):1440–1442.
15.
Meyberg-SolomayerGCHofbeckMMüller-HansenIKaulitzRZiemerG. Open heart surgery immediately after birth following prenatal diagnosis of a large right pulmonary artery to left atrium communication. Prenat Diagn. 2009;29(7):718–720.
16.
BoudjemlineYLadouceurMBonnetD. Neonatal transcatheter closure of a large pulmonary arteriovenous fistula. Cardiol Young. 2006;16(6):593–595.
17.
SaatvedtKStakeGLindbergH. Fistula between the right pulmonary artery and left atrium—an unusual cause of cyanotic heart disease. Cardiol Young. 1995;5(1):85–87.
18.
de Souza eSilvaNAGiulianiERRitterDGDavisGDPluthJR. Communication between right pulmonary artery and left atrium. Am J Cardiol. 1974;34(7):857–863.
19.
OharaHItoKKohguchiN. Direct communication between the right pulmonary artery and the left atrium. A case report and review of the literature. J Thorac Cardiovasc Surg. 1979;77(5):742–747.
20.
KarnikAMNilssonUVijaayaraghavanGHashmiJShuhaiberH. Direct communication between the left pulmonary artery and the left atrium. Chest. 1989;96(4):937–939.
21.
SambasivamKADhanawadeSMKrishnaswamiS. Direct communication between left pulmonary artery and left atrium. Ind Heart J. 1995;47(1):40–41.
22.
ChowdhuryUKKothariSSAiranBSubramaniamKGVenugopalP. Right pulmonary artery to left atrium communication. Ann Thor Surg. 2005;80(1):365–370.
23.
KüçükosmanogluOPoyrazogluHTopçuogluMSErdemSErmanTOzbarlasN. Right pulmonary artery-left atrial communication presenting with brain abscess: a case report. Turk J Pediatr. 2006;48(4):373–375.
24.
KavaranaMNDevaneyEJTorresMLCottsT. Right pulmonary artery to left atrial fistula: a rare presentation. World J Pediatr Congenit Heart Surg. 2012;3(3):382–384.
25.
KrishnamoorthyKMRaoS. Pulmonary artery to left atrium communication. Texas Heart Inst J. 2002;29(1):71–72.
26.
SrivastavaARadhaAS. Right pulmonary artery to left atrium fistula: transcatheter closure without conventional venovenous loop. J Invasive Cardiol. 2012;24(7):E145–E147.
27.
ZanchettaMRigatelliGPedonLZennaroMMaiolinoPOnoratoE. Transcatheter Amplatzer duct occluder closure of direct right pulmonary to left atrium communication. Catheter Cardiovasc Interv. 2003;58(1):107–110.
28.
FrancisESivakumarKKumarR. Transcatheter closure of fistula between the right pulmonary artery and left atrium using the Amplatzer duct occluder. Catheter Cardiovasc Interv. 2004;63(1):83–86.
29.
UthamanBAl-QbandiMAbushabanLRathinasamyJ. Transcatheter closure of large pulmonary arteriovenous fistula including pulmonary artery to left atrial fistula with Amplatzer septal occluder. Catheter Cardiovasc Interv. 2007;70(4):422–428.
30.
RamakrishnanSShivdasSKotharS. Trans-septal closure of a right pulmonary artery to left atrial communication. Catheter Cardiovasc Interv. 2010;75(7):1096–1099.
31.
ErgülYNişliKAydoğanU. Transcatheter closure of a fistula between the right pulmonary artery and left atrium using the Amplatzer septal occluder. Turk Kardiyol Dern Ars. 2011;39(3):231–234.
32.
RadEMArabi MY. Transcatheter closure of direct communication of main pulmonary artery to left atrium using muscular VSD occluder in an infant. Catheter Cardiovasc Interv. 2011;78(2):276–279.
