Agenesis of the Left Pulmonary Artery, as Incidental Finding

Jiménez Romero, Alexander Ali; Hernandez Olivo, Marta; Hernandez Caler, Rocio; Lerenas Bernal, Francisca; Cabello Jabalquinto, Maria del Rosario; Velasco Alcazar, Maria del Carmen

doi:10.1016/j.opresp.2023.100261

ISSN: 2659-6636

Open Respiratory Archives is one of the official publications from the Spanish Respiratory Society of Pulmonology and Thoracic Surgery (SEPAR) and a companion title to the highly-regarded Archivos de Bronconeumología. Open Respiratory Archives is a new online only, open access, peer reviewed journal that publishes original studies whose content is based upon results dealing with several aspects of respiratory diseases such as epidemiology, pathophysiology, clinics, surgery and basic investigation. Other types of articles such as reviews, editorials, clinical images, scientific letters, and letters to the Editor are also published in the Journal. In addition, the Journal may also publish society documents such as guidelines, position documents, statements, and consensus reports as long as redundancy with previous publications in other society journals does not exist or the degree of similarity is low. Authors of this type of society documents must prove scientific accreditation in the target areas. All the manuscripts received in the Journal are sent to peer-review and are handled by the Editor or an Associate Editor from the team. The official languages of the Journal are English and Spanish. Therefore, manuscripts can be submitted in either language. The areas covered in the Journal are of general interest to the average clinician dealing with respiratory patients, especially pulmonologists and thoracic surgeons. Other types of professionals may also find the contents published in the Journal of interest for their clinical practice: internists, radiologists, immunologists, physiotherapists, rehabilitators, primary care doctors, nurses, and other professionals.

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A 77-year-old female, with no respiratory history of interest, she consults for persistent respiratory infection symptoms of one month of evolution despite optimized medical treatment. In chest X-ray we did not observe pathological findings, so computed chest tomography (CT) with intravenous contrast (IV) was indicated and showed unilateral agenesis of the left pulmonary artery and ipsilateral pulmonary hypoplasia (Fig. 1).

Fig. 1.

(A) The absence of the left pulmonary artery and ipsilateral pulmonary hypoplasia in a coronal section of the pulmonary window. (B) Axial view of the mediastinal window showing contrast uptake only in the right pulmonary artery. (C) Coronal section in mediastinal window, showing hypertrophy of bronchial arteries with compensation for the agenesis of the left pulmonary artery.

(0.48MB).

Unilateral pulmonary artery agenesis is a rare and low prevalence case, with an estimated prevalence of one per 200,000–300,000 individuals.1 It is mainly secondary to an anomaly in the rotation and migration of the sixth primitive aortic arch in the fourth or fifth week of embryonic development. The right pulmonary artery agenesis is more frequent and has fewer complications since it is less associated with other malformations than the left one. It is usually diagnosed in childhood after repeated respiratory infections and incidentally in adults by imaging test.2

Currently, the most accepted treatment is conservative management in asymptomatic patients, and surgery in symptomatic patients.2

Pulmonary artery agenesis, although a rare disorder, should be considered as a differential diagnosis in patients with persistent infectious respiratory symptoms.

Informed consent

Written informed consent was obtained from the patient for publication of this case report and any accompanying images.

Funding

The authors declare that no funding was received for this article.

Authors’ contributions

All authors have contributed significantly to the research and preparation, revision and final production of the manuscript and approved its submission.

Conflicts of interest

The authors declare that they have no conflict of interest.

References

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E. Cabrera César, M.C. Fernández Aguirre, L. Piñel Jiménez.

Incidental finding of right pulmonary artery agenesis in an adult.

Arch Bronconeumol, 53 (2017), pp. 693-694

http://dx.doi.org/10.1016/j.arbres.2017.03.014 | Medline

[2]

V. Adán Lanceta, A. Jiménez Olmos, C. Martín de Vicente, J.P. García Íñiguez.

Agenesia aislada de la arteria pulmonar derecha.

An Pediatr (Barc), 86 (2017), pp. 45-46