Pulmonary sling: morphological findings. Pre- and postoperative course

Area of Science:

• Congenital cardiovascular anomalies
• Pediatric respiratory diseases
• Thoracic surgery

Background:

• Pulmonary sling (PS) is a rare congenital anomaly where the left pulmonary artery arises abnormally, encircling the trachea.
• It can cause severe airway obstruction in infants, often presenting with respiratory distress.
• Associated tracheal and cardiovascular anomalies are common, complicating diagnosis and management.

Purpose of the Study:

• To review the diagnostic modalities and management strategies for pulmonary sling.
• To highlight the importance of early diagnosis and surgical intervention.
• To discuss the challenges and outcomes associated with surgical repair.

Main Methods:

• Review of diagnostic imaging techniques including echocardiography, chest radiography, bronchography, bronchoscopy, MRI, CT, and angiography.
• Discussion of surgical management, primarily LPA reimplantation and division of the ligamentum arteriosum.
• Analysis of postoperative complications and long-term outcomes.

Main Results:

• Various imaging modalities aid in PS diagnosis, though interpretation requires care.
• Associated tracheal anomalies are frequent and impact surgical outcomes.
• Surgical repair offers relief of obstruction, but complications like restenosis can occur.
• Complete relief is more likely in the absence of tracheobronchial anomalies.

Conclusions:

• Pulmonary sling requires prompt diagnosis and surgical intervention for optimal outcomes.
• Management can be complex due to associated anomalies, necessitating tailored approaches.
• While surgical repair is effective, long-term follow-up is important for managing potential late complications.