Anomalous Origin of the Right Pulmonary Artery from the Ascending Aorta in an Adult After Prior Patent Ductus Arteriosus Surgery

We present an adult patient with a history of surgical treatment of a patent ductus arteriosus (PDA) in whom contrast-enhanced chest computed tomography (CT) demonstrated anomalous origin of the right pulmonary artery (RPA) from the ascending aorta. Axial CT images clearly demonstrate an discontinuity between the main pulmonary artery and the right pulmonary artery (RPA), and delineate an abnormal opening on the ascending aorta; multiplanar reconstruction technology precisely locates the origin of the artery; dynamic volume imaging integrates the three-dimensional anatomical structure into a model nearly equivalent to a surgical perspective. This case illustrates that an anomalous pulmonary artery associated with a ductus may remain unrecognized at the time of ductus surgery and persist into adulthood, and that a single contrast-enhanced CT examination with multiplanar and cinematic reconstruction provides comprehensive, single-session confirmation of the diagnosis, together with the anatomic roadmap required for surgical planning. For any patient undergoing PDA closure—particularly when pulmonary hypertension or right-heart dilation seems disproportionate—deliberate verification of the origin of both pulmonary arteries may prevent a missed lesion and a second, avoidable operation.