Direct communication between the left pulmonary artery and the left atrium.

A 17-year-old patient was found to have cyanosis. A right-to-left shunt was suspected clinically and confirmed by noninvasive techniques such as perfusion lung scan and contrast echocardiography. Angiography showed this shunt to be between the left pulmonary artery and the left atrium. We believe this to be the first report of a hitherto undescribed congenital anomaly.