Communication between right pulmonary artery and left atrium

The 12th case of a direct communication between the right pulmonary artery and the left atrium is reported, with special emphasis on the clinical and hemodynamic findings. The anatomic differences in the 12 cases are categorized into three general types: an anomalous vessel connecting the posterior aspect of the right pulmonary artery and draining into the left atrium with (1) normal pulmonary venous connections or (2) the pulmonary vein draining into the anomalous vessel; and (3) an anomalous communication draining into the left atrium in place of the absent right lower pulmonary vein. In patients with this anomaly, surgery should result in complete cure; early intervention is recommended because the mortality rate is higher for patients who are older at operation and because there is an increased chance that cerebral and Systemic emboli will occur if surgery is not performed.