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

• Published in: Canadian journal of cardiology Vol. 31; no. 9; pp. 1205.e1 - 1205.e2
• Main Authors: Ricci, Silvia, MD, Fainardi, Valentina, MD, Spaziani, Gaia, MD, Favilli, Silvia, MD, Chiappa, Enrico, MD
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01.09.2015
• Subjects: Adult; Alprostadil - administration & dosage; Aorta, Thoracic - abnormalities; Aorta, Thoracic - diagnostic imaging; Asymptomatic Diseases; Cardiovascular; Female; Heart Defects, Congenital - diagnostic imaging; Humans; Infusions, Intra-Arterial; Pulmonary Artery - abnormalities; Pulmonary Artery - diagnostic imaging; Radiography; Ultrasonography, Prenatal; Vasodilator Agents - administration & dosage
• ISSN: 0828-282X; 1916-7075
• DOI: 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.