# Anomalies Unveiled: A Fascinating Case Study of Type I Pulmonary Artery-to-Left Atrium Fistula

## TL;DR

A rare case of a pulmonary artery-to-left atrium fistula in an eight-year-old child is reported, with plans for percutaneous closure.

## Contribution

This paper presents a rare clinical case of type I RPA-to-LA fistula diagnosed via cardiac CT and discusses percutaneous closure as a treatment option.

## Key findings

- A child with central cyanosis and dyspnea was found to have a type I RPA-to-LA fistula.
- Cardiac CT confirmed normal pulmonary vein drainage into the left atrium.
- Percutaneous closure using an occluder device is planned for treatment.

## Abstract

The pulmonary artery-to-left atrium (LA) fistula is one of the rare and unique structural causes of silent cyanosis. This correctable abnormality can be identified by having a high index of clinical suspicion and appropriate investigations using echocardiography and cardiac computed tomography (CT). We report an eight-year-old child who had worsening exertional dyspnea, long-standing central cyanosis, and recurrent infections. A large-sized fistula connecting the right pulmonary artery (RPA) to the LA with all the right- and left-sided pulmonary veins showed normal drainage into the LA, suggesting a type I RPA-to-LA fistula, which was diagnosed on cardiac CT. Percutaneous closure using the occluder device is planned as further management for the patient.