Aortic Origin of the Left Pulmonary Artery in an Infant With Fallot's Tetralogy

We report the case of a male neonate who had a prenatal diagnosis of Fallot's tetralogy. He presented with respiratory distress during the second week of life. Chest x-ray showed an enlarged right ventricle and pulmonary edema. Echocardiography demonstrated characteristic features of Fallot's tetralogy. However, cardiac catheterization disclosed that, in this case of Fallot's tetralogy, the left pulmonary artery had an anomalous origin in the ascending aorta. At 23 days of age, the patient underwent total surgical correction of the defects, during which a direct anastomosis was employed without conduit placement. 10 days later, he was discharged. We present the results of a literature review of the epidemiological, physiopathological, clinical, diagnostic, and surgical characteristics of this rare condition. Presentamos el caso de un neonato con diagnóstico prenatal de tetralogia de Fallot. Durante la segunda semana de vida presentó dificultad respiratoria; en la radiografia de tórax se observó un aumento del ventriculo derecho con edema pulmonar. La ecocardiografia mostró los hallazgos de la tetralogia de Fallot. En el cateterismo cardiaco se encontró además un origen anómalo de la arteria pulmonar izquierda desde la aorta ascendente. A los 23 dias se realizó cirugia correctora con anastomosis directa sin utilizar interposición de conducto. Fue dado de alta hospitalaria 10 dias después. Revisamos la literatura médica de esta rara entidad, en sus hallazgos epidemio-lógicos, fisiopatológicos, clinicos, diagnósticos y quirúrgicos.