Fu Fengli, Yang Jiahu, Zhang Jianjun, Feng Yue
Department of Radiology, Zhejiang Hospital, No.12 Lingyin Rd, Hangzhou, 310013, China.
BMC Cardiovasc Disord. 2016 Sep 5;16(1):172. doi: 10.1186/s12872-016-0354-8.
Crossed pulmonary arteries or single atrium is a rare form of cardiovascular anomaly. In previous studies, the anomalies are detected in infant or early adolescence, and infrequently seen in adult population.
We presented a case of the coexistence of two congenital anomalies in a 44-year-old woman who remained well tolerated and undiscovered until adulthood. Physical examination showed a grade III systolic murmur at the cardiac apex, and a grade II/III systolic murmur at left 2-3 intercostal space. An echocardiography revealed absence of atrial septal tissue. Dual-source CT angiography was performed for further evaluation of the great vessel. Except an enlarged single atrium, the imaging showed that the origination of the left pulmonary artery from the pulmonary trunk was superior to that of the right pulmonary artery. The branch pulmonary arteries then crisscrossed as they coursed to their respective lungs. The findings were illustrated by the right heart catheterization and then confirmed at surgery.
To our knowledge, this is the first case report of crossed pulmonary arteries with single atrium as the only additional cardiac anomaly in an adult. Knowledge of this rare combination will be helpful in the differential diagnosis of congenital heart disease and assist the surgeon in treatment planning.
交叉肺动脉或单心房是一种罕见的心血管异常形式。在以往的研究中，这些异常在婴儿期或青春期早期被发现，在成人中很少见。
我们报告了一例44岁女性同时存在两种先天性异常的病例，该患者在成年前一直耐受性良好且未被发现。体格检查显示心尖部有III级收缩期杂音，左2-3肋间有II/III级收缩期杂音。超声心动图显示房间隔组织缺失。进行了双源CT血管造影以进一步评估大血管。除了单心房增大外，影像学显示左肺动脉起源于肺动脉干的位置高于右肺动脉。然后分支肺动脉在向各自肺部走行时相互交叉。这些发现通过右心导管检查得到证实，并在手术中得到确认。
据我们所知，这是第一例关于交叉肺动脉合并单心房且为成人唯一额外心脏异常的病例报告。了解这种罕见的组合将有助于先天性心脏病的鉴别诊断，并协助外科医生进行治疗规划。
