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08.05.2017 | Case report | Ausgabe 2/2018

Indian Journal of Thoracic and Cardiovascular Surgery 2/2018

Pulmonary artery sling—a case report

Zeitschrift:
Indian Journal of Thoracic and Cardiovascular Surgery > Ausgabe 2/2018
Autoren:
Divya Mallikarjun, Mahadev Damodar Dixit, Seetharama Padebettu Subramanya Bhat

Abstract

Vascular sling/pulmonary artery sling is a congenital anomaly in which the left pulmonary artery arises from the right pulmonary artery extrapericardially (anomalous left pulmonary artery), courses to the left behind the tracheal bifurcation and in front of the esophagus to reach the left lung hilum, and forms a sling around the trachea. The prevalence is 1 in every 17,000 school-aged children. We present a 1.5-year-old male child of consanguineous parentage with history of recurrent chest infection and stridor leading to repeated hospitalization. Chest X-ray showed right upper lobe collapse with hyper inflated right middle and lower lobes. Echocardiography revealed left pulmonary artery arising from the right pulmonary artery with no intracardiac shunt. Cardiac computed tomography diagnosed the pulmonary artery sling—left pulmonary artery arising from the right pulmonary artery and compromising the lumen of proximal portion of right bronchus leading to right upper lobe collapse. The surgery included complete mobilization of the left pulmonary artery from its origin and along its course behind the trachea. The left pulmonary artery was disconnected from the right pulmonary artery and was then brought out from behind the trachea and aorta and reimplanted to the main pulmonary artery in an end to side fashion. Child developed chest infection postoperatively, which was treated with intravenous antibiotics and was subsequently discharged on postop day 10. Child is on regular follow-up for the past 8 months and is doing well.

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