CTICasesCongenital Unilateral Absence of Right Pulmonary Artery with Aortic Coarctation, PDA, and Ascending Aortic Diverticulum
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Imaging findings
Cardiac CT in a neonate reveals severe aortic coarctation supplied by a large patent ductus arteriosus (PDA) that feeds the descending thoracic aorta. There is complete absence of the right pulmonary artery, with a dilated, hypertrophied right ventricle and bidirectional atrial septal defect (ASD). An unusual blind-ending vascular diverticulum arises from the ascending aorta and extends inferiorly into the pretracheal space.
Key takeaways
Complete absence of a unilateral pulmonary artery is a rare congenital anomaly that can be isolated or associated with other cardiovascular defects like PDA, ASD, or aortic coarctation. An unusual blind-ending vascular diverticulum arising from the ascending aorta in this setting may represent an embryologic remnant of a failed systemic collateral supply (MAPCA) or a primitive aortic arch branch.
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