CT in Demonstrating an Extremely Rare Left-Sided Partial Morphologically Right Pulmonary Artery Sling (original) (raw)
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European Journal of Cardio-Thoracic Surgery, 2005
Both the pulmonary artery sling and the aortopulmonary window are unusual and serious anomalies. In patients with sling the airway might be compromised by associated cartilaginous o-rings in variant segments. In aortopulmonary window the clinical presentations are similar to the large patent ductus arteriosus or ventricular septal defect, but the surgical procedure is quite difficult and different. We operated an infant with a rarely seen cardiac defect, the coexistence of left pulmonary artery sling and Type 3 aortopulmonary window, when he was 35 days old. Postoperative repeated bronchospasm caused prolonged ventilation and hospitalization. Patient was extubated 28 days later and discharged at the age of 80 days without any events. Besides, the reconstructed three-dimensional images of ultrafast computed tomography offered us an interesting view other than surgical findings. A case of two such rare lesions coexisting was not to be found in the literature review, so we report this case because of its rarity and clinical interest.
A Rare Case of Pulmonary Artery Sling with the VACTERL Association in a 20-Month-Old Infant
The journal of Tehran Heart Center, 2017
The VACTERL association, co-occurrence of vertebral, anorectal, cardiac, tracheoesophageal, genitourinary, and limb malformations, is a rare congenital anomaly. Several cardiac anomalies have been reported as a part of the VACTERL association, particularly ventricular and atrial septal defects. Pulmonary artery sling is a rare congenital abnormality in which the left pulmonary artery arises from the right pulmonary artery. This anomaly is not frequently observed in the VACTERL association and has been rarely reported. A 20-month-old girl was admitted to our hospital due to pneumonia in the right lung, which had pulmonary artery sling as a part of the VACTERL association. Barium meal X-ray showed pressure effects on the esophagus, and computed tomography angiography revealed pulmonary artery sling. Pneumonia management was done. However, the parents of our patient refused to give consent for the surgical correction of this vascular anomaly. Three months after discharge from the hospi...
A Case of Pulmonary Artery Sling Anomaly with Tracheal Stenosis and Management of Difficult Airway
Journal of Pediatric Intensive Care, 2020
Pulmonary artery sling is a rare congenital vascular abnormality, where the left pulmonary artery originates from the right pulmonary artery, passes between trachea, and esophagus and reaching the left hilum. Cough, wheezing, and difficulty in feeding are three major symptoms. Untreated pulmonary sling carries high morbidity and mortality, most of which is due to the airway and other associated anomalies. Herein, we reported a 40-day-old male infant who admitted to the pediatric intensive care unit with progressive respiratory distress and diagnosed with left pulmonary sling with tracheal stenosis. We discussed the diagnosis and management of pulmonary artery sling and present the successful use of laryngeal mask in difficult airway management.
Pulmonary artery sling anomaly presenting with unilateral lung hyperinflation: a case r
The Turkish Journal of Pediatrics, 2018
Left pulmonary artery sling is a rare congenital pulmonary artery anomaly which presents with tracheal compression due to vascular ring formation. Rarely, patients may present with hyperinflation or collapse of a lung unilaterally. We present a one-month-old infant with dyspnea who had a hyperinflated left lung and collapsed right lung. Computed tomography (CT) angiography demonstrated pulmonary sling causing compression of proximal parts of right and left main bronchi. This case highlights the importance of three-dimensional CT angiography in evaluation of thoracic vascular anomalies associated with tracheobronchial pathologies.
Echocardiography, 2008
We report an interest and mystifying cardiovascular imaging in a 22q11 deletion neonate with rare congenital heart defects, including anomalous origin of the left pulmonary artery arising from the right pulmonary artery and in front of the trachea, called pseudo-pulmonary artery sling, combined with isolated left subclavian artery confirmed by multidetector row computed tomography. (ECHOCARDIOGRAPHY, Volume 25, September 2008) 22q11 deletion, isolated subclavian artery, pulmonary artery sling Anomalous origin of the left pulmonary artery (LPA) arising from the right pulmonary artery (RPA), pulmonary artery sling, is a rare but serious congenital anomaly. Affected infants generally present with respiratory distress and feeding problems during the early infancy. This anomaly can be associated with other cardiac defects, including tetralogy of Fallot (TOF), and echocardiography can provide an accurate diagnosis. 1,2 Right aortic arch with isolation of branchiocephalic vessels is also relatively uncommon. This anomaly includes isolated left subclavian artery (LSCA), the left common carotid artery or the left innominate artery. Herein we present a case of a 1-week-old male neonate with TOF, right aortic arch, and 22q11 deletion syndrome. Typical imaging of anomalous origin of the LPA from the RPA and coursing posteriorly and leftward in the parasternal short-axis plane was detected by transthoracic echocardiography. The main pulmonary artery (MPA) did not bifurcate in the usual location . Although there were no vascular slingrelated symptoms, such as respiratory distress or feeding problems in this patient, multidetec-
Left Pulmonary Artery Sling Complex: Computed Tomography and Hypothesis of Embryogenesis
The Annals of Thoracic Surgery, 2007
Embryogenesis Left Pulmonary Artery Sling Complex: Computed Tomography and Hypothesis of http://ats.ctsnetjournals.org/cgi/content/full/84/5/1645 located on the World Wide Web at: The online version of this article, along with updated information and services, is Print ISSN: 0003-4975; eISSN: 1552-6259. Southern Thoracic Surgical Association.
Italian heart journal : official journal of the Italian Federation of Cardiology, 2004
We report a case of an anomalous origin of the right pulmonary artery (RPA) from the ascending aorta diagnosed at echocardiography at 13 days of age. The diagnostic clue was relieved in the suprasternal and parasternal high short-axis views, showing aorto-RPA continuity with a systolic flow in the left pulmonary artery and a systo-diastolic flow in the RPA. At 34 days of age the infant was submitted to surgery during which a direct end-to-lateral anastomosis without conduit interposition was performed. During the short-term follow-up the patient developed RPA stenosis at the anastomosis site and underwent percutaneous stent implantation.
Left pulmonary artery sling with tracheal stenosis
Tạp chí Nghiên cứu và Thực hành Nhi khoa
We present the case of a 4-year-old girl, bronchofiberscopy (scope diameter 2.8mm): one third below oftrachea, which was divided into two orifices. The orifice on the right side was larger and divided into twosuborifices. The left orifice was stenosis and could not pass the bronchoscope. Whole trachea mucosa was redand edema, and could not observe the cartilage ring of trachea. Chest X-ray: infiltration of right lower lobe.Chest CT multiple probes with contrast injection confirmed that: At the sixth to seventh thoracic vertebral level,the left pulmonary artery was arisen from the right pulmonary artery then passed in between the behindtrachea and anterior oesophagus to reach the left lung hilar. And at the fourth to fifth thoracic vertebral level,the right upper bronchus was arisen from trachea and then the trachea was shrunk diameter to reach the leftlung hilar, at the end, the trachea divided 2 bronchi: left main bronchus and “bridging bronchus”. Thatbronchus from left lung hilar ...
Cardiovascular Imaging Asia
Left pulmonary artery sling (LPAS) is a rare congenital anomaly in which the left pulmonary artery (LPA) originates from the posterior aspect of the right pulmonary artery and courses between the trachea and esophagus to reach the left lung. This anomaly causes distal tracheal and/or right main stem bronchus compression. Most LPAS cases are associated with early symptom onset, around 2 month-old, and have severe respiratory distress within the first year of life. There are two major types of LPAS based on the location of LPA and abnormal bronchial branching. The diagnosis can be made by using various imaging modalities. Herein, we present the imaging characteristics on multidetector computed tomography of 5 LPAS cases with respiratory distress (2 months to 12 months).