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[Aberrant left pulmonary artery and tracheal abnormality]
P Rebaud1, J P Dalmas, G Bellon
1Service de Pédiatrie, Centre Hospitalier Lyon-Sud.
Insights
A rare congenital heart defect, left pulmonary artery sling, caused severe breathing problems in an infant. Surgical repair improved the infant's respiratory status, resolving the need for mechanical ventilation.
Area of Science:
- Pediatric Cardiology
- Thoracic Surgery
- Congenital Malformations
Background:
- Left pulmonary artery sling is a rare congenital anomaly where the left pulmonary artery arises from the right pulmonary artery and passes between the trachea and the esophagus.
- Tracheobronchial tree malformations can coexist with vascular anomalies, leading to complex respiratory issues in infants.
- Infants with these conditions often present with severe respiratory distress requiring mechanical ventilation.
Abstract:
A case of left pulmonary artery sling and tracheobronchial tree malformation is reported in a 3 month-old infant. Acute respiratory presenting symptoms required mechanical ventilatory support. The malformation was suspected because of ventilatory support difficulties. Barium oesophagogram showed an anterior indentation, fiberoptic bronchoscopy and tracheobronchography showed a severe tracheal stenosis from a right bronchus lobaris superior to the carina. This was worsened by the right side compression of trachea end part, due to the abnormal left pulmonary artery as demonstrated by pulmonary angiography. A surgical left artery transposition relieved lateral compression and allowed weaning of ventilatory support. After a 27 month-follow-up, the girl's respiratory status is satisfactory.