{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T05:51:50Z","timestamp":1757310710168,"version":"3.37.0"},"reference-count":7,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Egypt Heart J"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Anomalous origin of the right pulmonary artery (AORPA) from the ascending aorta is a rare congenital anomaly, representing approximately 0.12% of all congenital heart defects. Early diagnosis and timely intervention are essential to prevent severe complications such as heart failure and pulmonary vascular disease.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Case presentation<\/jats:title>\n            <jats:p>We report a case of a full term neonate presented with respiratory distress and cyanosis. Echocardiography revealed an anomalous right pulmonary artery (RPA) origin from the ascending aorta, a large patent ductus arteriosus (PDA) with right-to-left shunt, and moderate tricuspid regurgitation. Despite initial management with prostaglandin E1 (PGE1) infusion, discontinuation of the drug led to clinical deterioration characterized by severe metabolic acidosis and low cardiac output syndrome. Resuming PGE1 infusion stabilized the patient\u2019s hemodynamics and improved systemic blood flow, allowing for successful surgical repair.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>In cases of AORPA associated with aortic arch flow reversal, pulmonary hypertension, and inadequate interatrial communication, maintaining PDA patency with PGE1 infusion until surgical repair is critical for survival. The right-to-left flow across the PDA counteracts the steal from the aorta and decompresses the right ventricle, preventing right ventricular failure\u00a0and maintaining systemic blood flow.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical abstract<\/jats:title>\n          <\/jats:sec>","DOI":"10.1186\/s43044-025-00614-6","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T11:55:16Z","timestamp":1738670116000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Unusual presentation of anomalous origin of the right pulmonary artery from the ascending aorta: case report"],"prefix":"10.1186","volume":"77","author":[{"given":"Mohamed","family":"Elhudairy","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naif","family":"Alkhushi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osman","family":"Al-Radi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khadijah","family":"Maghrabi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0361-2921","authenticated-orcid":false,"given":"Gaser","family":"Abdelmohsen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,2,4]]},"reference":[{"issue":"10","key":"614_CR1","doi-asserted-by":"publisher","first-page":"1536","DOI":"10.1111\/echo.13674","volume":"34","author":"N Alkhushi","year":"2017","unstructured":"Alkhushi N, Al-Radi OO, Ajlan A, Abdelmohsen G, Attia W (2017) Coronary-pulmonary arterial fistula in a neonate with pulmonary atresia-ventricular septal defect and single coronary artery. Echocardiography 34(10):1536\u20131539. https:\/\/doi.org\/10.1111\/echo.13674","journal-title":"Echocardiography"},{"key":"614_CR2","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1007\/978-4-431-99470-1_26","volume-title":"Cardiovascular Surgery for Congenital Heart Disease","author":"K Fukae","year":"2009","unstructured":"Fukae K (2009) Anomalous Origin of the Right Pulmonary Artery from the Ascending Aorta. In: Yasui H, Kado H, Masuda M (eds) Cardiovascular Surgery for Congenital Heart Disease. Springer Japan, Tokyo, pp 159\u2013161. https:\/\/doi.org\/10.1007\/978-4-431-99470-1_26"},{"issue":"2","key":"614_CR3","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1111\/j.0886-0440.2004.04023.x","volume":"19","author":"E Prifti","year":"2004","unstructured":"Prifti E, Bonacchi M, Murzi B et al (2004) Anomalous origin of the right pulmonary artery from the ascending aorta. J Card Surg 19(2):103\u2013112. https:\/\/doi.org\/10.1111\/j.0886-0440.2004.04023.x","journal-title":"J Card Surg"},{"issue":"18","key":"614_CR4","doi-asserted-by":"publisher","first-page":"2749","DOI":"10.2169\/internalmedicine.2455-18","volume":"58","author":"R Ueno","year":"2019","unstructured":"Ueno R, Yagi S, Bando M, Sata M (2019) Long-surviving anomalous origin of the right pulmonary artery from the ascending aorta complicated with pulmonary arteriovenous fistula. Intern Med 58(18):2749\u20132750. https:\/\/doi.org\/10.2169\/internalmedicine.2455-18","journal-title":"Intern Med"},{"issue":"5","key":"614_CR5","doi-asserted-by":"publisher","first-page":"e37","DOI":"10.1016\/j.jcct.2018.12.053","volume":"14","author":"H Bu","year":"2020","unstructured":"Bu H, Gong X (2020) Image diagnosis: an anomalous origin of right pulmonary artery from the ascending aorta. J Cardiovasc Comput Tomogr 14(5):e37\u2013e39. https:\/\/doi.org\/10.1016\/j.jcct.2018.12.053","journal-title":"J Cardiovasc Comput Tomogr"},{"issue":"3","key":"614_CR6","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1007\/BF01915623","volume":"43","author":"O Fraentzel","year":"1868","unstructured":"Fraentzel O (1868) Ein Fall von abnormer communication der Aorta mit der Arteria pulmonalis. Archiv f pathol Anat 43(3):420\u2013426. https:\/\/doi.org\/10.1007\/BF01915623","journal-title":"Archiv f pathol Anat"},{"issue":"7","key":"614_CR7","doi-asserted-by":"publisher","first-page":"1532","DOI":"10.1007\/s00246-015-1197-2","volume":"36","author":"S Cho","year":"2015","unstructured":"Cho S, Kim W-H, Choi ES, Lee JR, Kim YJ (2015) Surgical results of anomalous origin of one pulmonary artery branch from the ascending aorta. Pediatr Cardiol 36(7):1532\u20131538. https:\/\/doi.org\/10.1007\/s00246-015-1197-2","journal-title":"Pediatr Cardiol"}],"container-title":["The Egyptian Heart Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s43044-025-00614-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s43044-025-00614-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s43044-025-00614-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T11:55:20Z","timestamp":1738670120000},"score":1,"resource":{"primary":{"URL":"https:\/\/tehj.springeropen.com\/articles\/10.1186\/s43044-025-00614-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,4]]},"references-count":7,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["614"],"URL":"https:\/\/doi.org\/10.1186\/s43044-025-00614-6","relation":{},"ISSN":["2090-911X"],"issn-type":[{"value":"2090-911X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,4]]},"assertion":[{"value":"20 August 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 January 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 February 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent was obtained directly from the patient\u2019s parents to publish this case report, so ethical approval is not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient\u2019s parents to publish this case report.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"20"}}