Unexpected Cause of Cyanosis and Dyspnea in an Adult: Direct Communication of the Right Pulmonary Artery and Left Atrium Ismail Dogu Kilic, MD, Yusuf.

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Unexpected Cause of Cyanosis and Dyspnea in an Adult: Direct Communication of the Right Pulmonary Artery and Left Atrium Ismail Dogu Kilic, MD, Yusuf I. Alihanoglu, MD, Nevzat Karabulut, MD, Fırat Durna, MD, Bilgin Emrecan, MD The Annals of Thoracic Surgery Volume 97, Issue 5, Pages 1782-1784 (May 2014) DOI: 10.1016/j.athoracsur.2013.08.027 Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) Chest roentgenogram showing a rounded opacity at the right border of the heart. (B) Echocardiogram showing an aneurysmal sac adjacent to the left atrium (arrow). The Annals of Thoracic Surgery 2014 97, 1782-1784DOI: (10.1016/j.athoracsur.2013.08.027) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Injection of right pulmonary artery during conventional angiography. Arrows show the aneurysm. (LA = left atrium.) The Annals of Thoracic Surgery 2014 97, 1782-1784DOI: (10.1016/j.athoracsur.2013.08.027) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Intraoperative images of the aneurysmal sac. (A) Before ligation. Pulmonary artery (PA) fistulizing to the aneurysmal sac; asterisk shows tape encircling the right superior pulmonary vein. (B) After ligation. Arrows show staple lines. (RA = right atrium.) The Annals of Thoracic Surgery 2014 97, 1782-1784DOI: (10.1016/j.athoracsur.2013.08.027) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions