{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:04:00Z","timestamp":1756425840311,"version":"3.44.0"},"reference-count":8,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,4,14]]},"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:p>A female patient in her early 30s, with a medical history of pulmonary arterial hypertension associated with congenital heart disease, lost to follow-up, was referred to a pulmonary hypertension reference centre. The patient presented at a WHO functional class of II in a low-risk category. A transthoracic echocardiogram demonstrated severe pulmonary hypertension with right ventricular dysfunction. A cardiac MRI demonstrated a right aortic arch with anomalous origin of the left pulmonary artery from the ascending thoracic aorta and a patent ductus arteriosus. A right heart catheterisation confirmed the presence of severe pulmonary hypertension. The patient was started on combined vasodilator therapy with an improvement in symptoms and remaining in a low-risk category. This represents one of the oldest described cases of such an anomaly and the first description of response to vasodilator therapy, highlighting the importance of a structured approach in a reference centre for achieving optimal outcomes.<\/jats:p>","DOI":"10.1136\/bcr-2021-247070","type":"journal-article","created":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T13:06:53Z","timestamp":1653311213000},"page":"e247070","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Anomalous origin of the left pulmonary artery from the ascending thoracic aorta and a right patent ductus arteriosus associated with pulmonary hypertension in a woman of childbearing age: an unprecedented approach"],"prefix":"10.1136","volume":"15","author":[{"given":"Jo\u00e3o Grade","family":"Santos","sequence":"first","affiliation":[{"name":"Cardiology, Hospital Garcia de Orta EPE, Almada, Set\u00fabal, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filipa","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Cardiology, Hospital Garcia de Orta EPE, Almada, Set\u00fabal, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8745-3541","authenticated-orcid":false,"given":"Sofia","family":"Alegria","sequence":"additional","affiliation":[{"name":"Cardiology, Hospital Garcia de Orta EPE, Almada, Set\u00fabal, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helder","family":"Pereira","sequence":"additional","affiliation":[{"name":"Cardiology, Hospital Garcia de Orta EPE, Almada, Set\u00fabal, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,5,11]]},"reference":[{"key":"2025082803543902000_15.5.e247070.1","doi-asserted-by":"crossref","first-page":"38-50","DOI":"10.1016\/j.carpath.2018.11.004","article-title":"Congenital abnormalities of the aortic arch: revisiting the 1964 Stewart classification","volume":"39","author":"Li","year":"2019","journal-title":"Cardiovasc Pathol"},{"key":"2025082803543902000_15.5.e247070.2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(88)91078-8"},{"key":"2025082803543902000_15.5.e247070.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(99)80787-5"},{"key":"2025082803543902000_15.5.e247070.4","doi-asserted-by":"crossref","first-page":"e181","DOI":"10.1016\/j.athoracsur.2018.07.083","article-title":"Anomalous origin of left pulmonary artery from the aorta: a rare entity in congenital heart disease","volume":"107","author":"Gropler","year":"2019","journal-title":"Ann Thorac Surg"},{"key":"2025082803543902000_15.5.e247070.5","first-page":"534","article-title":"Origin of the right pulmonary artery from the ascending aorta in a 25-year-old man","volume":"33","author":"Wu","year":"2006","journal-title":"Tex Heart Inst J"},{"key":"2025082803543902000_15.5.e247070.6","doi-asserted-by":"publisher","DOI":"10.1007\/s11604-015-0391-8"},{"key":"2025082803543902000_15.5.e247070.7","doi-asserted-by":"crossref","first-page":"e439","DOI":"10.1016\/j.athoracsur.2016.04.089","article-title":"Isolated anomalous origin of left pulmonary artery from the descending aorta: an embryologic ambiguity","volume":"102","author":"Gnanappa","year":"2016","journal-title":"Ann Thorac Surg"},{"key":"2025082803543902000_15.5.e247070.8","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv317"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-247070","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:54:51Z","timestamp":1756378491000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-247070"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5]]},"references-count":8,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,5,11]]},"published-print":{"date-parts":[[2022,5]]}},"alternative-id":["10.1136\/bcr-2021-247070"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-247070","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2022,5]]}}}