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Canadian Journal of Cardiology

Right Aortic Arch Detected Prenatally: A Rare Case With Bilateral Arterial Duct and Nonconfluent Pulmonary Arteries

Published:April 01, 2015DOI:https://doi.org/10.1016/j.cjca.2015.03.030

      Abstract

      We describe a rare case of right aortic arch (RAA) and nonconfluent pulmonary arteries. RAA and a right-sided arterial duct (AD) were identified on the prenatal scan, but a second left-sided AD and disconnection of the left pulmonary artery were missed. The missed diagnosis in fetal life adversely affected postnatal management. We suggest that fetuses with a prenatal diagnosis of RAA and right-sided AD be delivered in tertiary care centres to rule out an association with bilateral AD and nonconfluent pulmonary arteries after birth. Prompt postnatal diagnosis will enable preservation of flow in the disconnected pulmonary artery through prostaglandin E1 infusion until surgical reconstruction.

      Résumé

      Nous décrivons un cas rare d’arc aortique droit (AAD) et d’artères pulmonaires non confluentes. La echocardiographie prénatale a montré un AAD et un canal artériel (CA) droit, mais n’a pas décelé le deuxième CA gauche et la déconnexion de l’artère pulmonaire gauche. L’erreur de diagnostic au cours de la vie fœtale a des conséquences négatives sur la prise en charge postnatale. Nous suggérons que les mères porteuses d’un fœtus pour lequel le diagnostic prénatal montre un AAD et un CA droit soient dirigées dans des centres de soins tertiaires pour exclure une association de CA bilatéral et d’artères pulmonaires non confluentes après la naissance. Le diagnostic postnatal rapide permettra de préserver le flux de l’artère pulmonaire déconnectée par la perfusion de prostaglandine E1 jusqu’à la reconstruction chirurgicale.
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