Pulmonary artery agenesis associated with coronary collaterals among adults

Unilateral agenesis of the pulmonary artery is a rare congenital anomaly, which commonly involves the right side. Cases are associated with systemic collaterals, that may also arise from the coronary arteries. Two adult patients are presented with exertional dyspnea. Investigations revealed a right pulmonary artery agenesis associated with collaterals from right coronary artery. The implication of such an anomaly was different among both patients due to associated systemic collaterals and congenital heart lesions. Both patients were treated medically to control pulmonary artery pressure. Adult patients with pulmonary artery agenesis have variable presentations and hemodynamic conditions. The presence of associated congenital heart disease and extensive systemic collaterals play a major role in hemodynamics. The association of coronary collaterals is rare and its implication varies from no effect to ischemic manifestations and myocardial infarction.