Direct communication of the right pulmonary artery with the left atrium in an infant.

An 8-month-old Japanese girl with cyanosis and evidence of a round shadow connected with the right cardiac border on the chest X-ray film was diagnosed as a case of direct communication of the right pulmonary artery with the left atrium (RPA-LA communication) following cardiac catheterization and angiocardiography. She had a history of transient congestive heart failure in the early neonatal period. A secundum atrial septal defect and a two-lobed right lung were also present. The patient became asymptomatic after a successful ligation of the anomalous connecting vessel.