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KMID : 0378019710140110057
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New Medical Journal
1971 Volume.14 No. 11 p.57 ~ p.72
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Ectopic origin of the Pulmonary Artery
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Abstract
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A study on ectopic origin of the pulmonary artery was done in 32 dogs. Intrapericardial right pulmonary artery-ascending aorta end-to-side anastomosis was done. Out of 32 dogs 8 dogs expired, 4 due to cardiac arrest and 4 by operative bleeding. Postoperatively five dogs expired due to intractable acute congestive failure, refractory to digitalization.
Eighteen long-term and 5 short-term survivors were obtained. One, two, three, four, and five months post-operative long-term survivors were sacrificed after auscultation of the chest and pulmonary arteriography.
The following observations were made.
1) On the postero-lateral chest wall, continuous machinery murmur was auscultated in every long-term survivors, showing patency of anastomosis stoma of the great vessels.
2) Pulmonary arteriography through the left ventricular apical injection showed simultaneous opacification
of the ascending aorta and right pulmonary artery. No visualization of the non-anastomosed left side lung
was the rule. In some cases dilatation of the peripheral pulmonary arteries were noted.
3) Macroscopically postoperative lung showed fibrotic and congestive changes with increased consistency. 4) Microscopic findings:
In one month group parenchymal changes showed congestion, thickening of alveolar wall pleura, and scattered round cell infiltration.
In some area alveolar rupture and irregularities were noted. Slight medial hypertrophy was noted in pulmonary arterioles. In non-anastomosed side i. e. left lung pulmonary congestion was present but no vascular changes were noted.
In two months group vascular wall changes and parenchymal changes of alveolar and pleural thickening
increased in intensity.
In three months group obstructive vascular changes were very prominent in muscular arteries and pulmonary arterioles, showing medial hypertrophy and intimal proliferation. Parenchymal and pleural changes were more prominent than two months group.
In four and five months group obstructive vascular changes were not remarkably intensified compared
with three months group, showing these-changes have progressed to its maximal grade after three months and thereafter little aggravation occurred.
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