[A case of re-operation after 14 years following radical correction of the anomalous origin of right pulmonary artery from ascending aorta].

Anomalous origin of the right pulmonary artery from the ascending aorta is a rare congenital malformation, which is usually fatal without early surgical correction. The number of reports of the radical operation has been recently increasing, but reports of its long-term postoperative results are rare, especially those of the reoperative cases. The 14-year-old patient, who had been operated radically with a 8 mm diameter graft at 7 months of age, weighing 4550 g at the time, was reoperated, because he developed pulmonary hypertension due to the narrowing of the graft. He had no clinical symptoms and no abnormal signs on chest X-P nor ECG, eventhough severe stenosis of the graft was present. The graft was replaced with a larger 12 mm diameter graft under ECC, and PFO closure and TAP were done at the same time. The patient's pulmonary artery pressure reduced substantially following surgery. We conclude that cautious postoperative follow-up including angiographical examination is important, and that early reoperation before occlusion of the graft should be done.