PMC3634253_01
Three-dimensional volume rendering image showing the anomalous right pulmonary artery arising from the right posterior aspect of the ascending aorta, the left pulmonary artery arising normaly from the main pulmonary artery, large patent ductusarteriosus, and arch hypoplasia with coarctation of aorta
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F1
Thoracic computerised tomography (CT) angiography was performed, and clearly revealed the right pulmonary artery arising from the posterior wall of the ascending aorta, along with tubular hypoplasia of the aortic arch to the isthmus portion, and large PDA [Figure 1].
PMC3634253_02
One stage pulmonary double-flap and arch extended end-to-end reconstruction surgery. (a) The diagrammatic section of diseased abnormality. (b) Aortic and pulmonary flap preparation with PDA ligated. (c) The neo right pulmonary artery was created by aortic flap and MPA flap suturing with end-to-end anastomosed ascending aorta caused aorta retract more posteriorly. (d) Under systemic circulatory arrest with selective antegrade cerebral perfusion, extended end-to-end surgical correction for coarctation of aorta
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F2
The double-flap technique for AOPRA repair was then followed [Figure 2].
The postoperative three-dimensional volume rendering image illustrated that the reconstructed aortic arch. (a) and neo-right pulmonary artery (b) were smooth and unobstructed
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F3
The follow-up CT angiography six months later illustrated that the reconstructed aortic arch and neo-right pulmonary artery were smooth and unobstructed [Figure 3].