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Pulmonary artery sling with tracheo-bronchial stenosis: report of one case
1Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan, R.O.C.
Insights
A rare congenital heart defect, pulmonary artery sling, caused airway obstruction in an infant. This condition, along with tracheobronchial stenosis, led to fatal cyanosis and cardiac arrest.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Respiratory Medicine
Background:
- Infants can present with complex congenital anomalies affecting both the cardiovascular and respiratory systems.
- Pulmonary artery sling, a rare anomaly, can cause significant morbidity and mortality in neonates and infants.
- Tracheobronchial stenosis can exacerbate respiratory distress in infants with congenital heart disease.
Abstract:
This patient is a 6-month-old female baby with intermittent symptoms of air-way obstruction for two months. The diagnostic examinations performed included: esophagogram, two-dimensional echocardiography, cardiac catheterization with selective right pulmonary arteriography, magnetic resonance imaging (MRI) and tracheo-bronchogram. The esophagogram revealed anterior indentation of the esophagus. The echocardiogram, cardiac catheterization and MRI all demonstrated anomalous origin of the left pulmonary artery from the right pulmonary artery instead of the main pulmonary artery. The tracheo-bronchogram showed long-segment stenosis of the lower portion of the trachea. A final diagnosis of pulmonary artery sling with tracheo-bronchial stenosis was made. Since the parents refused surgery, the baby expired after several episodes of cyanosis & cardiac arrest.