An Unusual Form of Anomalous Origin of the Right Pulmonary Artery from the Ascending Aorta, or Aorto-Pulmonary Window?

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Anomalous origin of the right pulmonary artery from the ascending aorta is characterized by the right pulmonary artery arising from the right or posterior aspect of the ascending aorta. The anomalous right pulmonary artery is seldom connected to the pulmonary trunk. A premature baby was diagnosed with this malformation. The right pulmonary artery arose from the left aspect of the ascending aorta and additionally communicated with the pulmonary trunk via a small lumen just distal to its aortic origin. She underwent reimplantation of the right pulmonary artery to the pulmonary trunk at 13 days old. She remained asymptomatic at five years postoperatively. There were only three cases reported describing continuous tissues between the right pulmonary artery and the pulmonary trunk. In embryogenesis, imbalanced and incomplete septation of the aortic sac may result in this rare circumstance.