Retrospective Echocardiographical Analysis of Unilateral Absence of Pulmonary Artery

Objective: To investigate the value of echocardiography in diagnosing unilateral absence of pulmonary artery (UAPA). Methods: The pulmonary artery branches were examined on the parasternal aortic root short axis and pulmonary artery branch view by echocardiography; Colour Doppler was further used to confirm the absence of left pulmonary artery and the absence of right pulmonary artery. The results of echocardiography were compared with that of surgery, X-ray angiography, magnetic resonance (MR) and computed tomography (CT). Results: The diagnosis of UAPA in 13 patients was confirmed by surgery, X-ray angiography, MR and CT. Among the 13 UAPA patients, 11 were diagnosed initially by echocardiography, and 2 missed diagnosis. For 3 of the 11 UAPA patients, pulmonary arteries were displayed ambiguously on the parasternal aortic root short axis views, but clearly on the parasternal pulmonary artery branch views. The 11 patients had significant expansion of their single pulmonary artery, and the mean ratio of the expanded pulmonary artery diameter/the main pulmonary artery diameter was 0.83±0.13. Two UAPA patients were complicated with lung dysplasia. Conclusion: The parasternal pulmonary artery branch view is more potent in diagnosing UAPA than the parasternal aortic root short axis view. The ratio of the left/right pulmonary artery diameter and the main pulmonary artery diameter around 0.8 should raise consideration for UAPA. Lung dysplasia should be considered in UAPA children.