Repair of an anomalous origin of the left pulmonary artery from the ascending aorta.

Anomalous origin of a left pulmonary artery from the ascending aorta is a very uncommon congenital cardiac malformation. Different surgical techniques have been employed. The direct implantation has been the strategy of choice. However, postoperative restenosis across the anastomotic site is frequently observed. We present a case in which a flap of the left pulmonary artery was used downward along the main pulmonary artery after excision, in a transverse diamond-shape, of the fusion of the media wall between them. This technique is feasible and effective to achieve a noncircular anastomosis without any prosthetic material.