Chest
Volume 72, Issue 1, July 1977, Pages 67-71
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Aberrant Left Pulmonary Artery: Clinical and Embryologic Factors

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The case of an infant with a pulmonary arterial sling (or aberrant left pulmonary artery) is presented. Associated congenital anomalies found in the original patient and in each of four other patients with this lesion, identified from postmortem files, are noted. The importance of associated anomalies of the respiratory tract is emphasized, since if present, they may affect the outcome after successful surgical correction of the vascular lesion. Previous theories of the embryologic origin of the anomalous artery are discussed, and a new theory is presented.

Section snippets

Case Report

An infant was seen at 2½ months of age with a history of inspiratory and expiratory stridor that had been present since birth. Growth and development were completely within normal limits, as were the findings from physical examination, with the exception of the examination of the cardiorespiratory system. Maximal cardiac sounds were heard loudest over the right side of the chest, and harsh stridulous breathing was noted on both inspiration and expiration. Normal breath sounds were noted

Discussion

The diagnosis of pulmonary arterial sling may be suspected on the basis of clinical symptoms and radiographic findings. Respiratory distress, if present, usually manifests itself during early infancy. Signs of expiratory obstruction may predominate, since compression of the distal airway may occur either where the anomalous vessel courses up and over the right main-stem bronchus or at the point where it passes between the distal trachea and esophagus just above the carina (Fig 1).

Suggestive

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There are more references available in the full text version of this article.

Cited by (42)

  • Partial anomalous left pulmonary artery in heterotaxy syndrome. A case report and review of literature

    2021, Progress in Pediatric Cardiology
    Citation Excerpt :

    It has been described in association with normal hearts [9–11], coarctation of the aorta with mitral stenosis [12,13], double outlet right ventricle (DORV), hypoplastic left heart, pulmonary stenosis, subaortic ventricular septal defect VSD, and atrial septal defect [12,14], multiple VSDs, and a PDA [2,3,15], partial AV canal [16], hypoplastic left heart syndrome [7], tetralogy of Fallot [7], and Kabuki syndrome [17–19]. Bamman et al. reported a case of two LPAs- one arising from its expected origin and the second arising from the RPA, circling over right lower bronchus and passing between trachea and esophagus forming a pulmonary artery sling with distal tracheal compression [9]. Koch et al. described a duplicated LPA, associated with coarctation of the aorta, mitral stenosis, and an imperforate anus, which did not form a partial pulmonary artery sling or any effect on the airway [13].

  • Partial Form of a Pulmonary Artery Sling

    2009, Annals of Thoracic Surgery
  • Left Pulmonary Artery Sling Complex: Computed Tomography and Hypothesis of Embryogenesis

    2007, Annals of Thoracic Surgery
    Citation Excerpt :

    From our data, we presented strong correlation among them. It is believed that the cause of LPA sling is multifactorial [12]. There is evidence of genetic-related factors such as the case report of LPA sling in identical twins [13], and in patients with trisomies 18 [14] and 21 [13, 15].

  • Noninvasive diagnosis of partial anomalous left pulmonary artery

    2001, Journal of the American Society of Echocardiography
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Manuscript received May 26; revision accepted November 22.

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