Surgical correction of pulmonary artery sling causing tracheal obstruction in infancy: rapid and complete recovery

Hüseyin Sicim ^* Daniel A. Velez Mohamad Alaeddine

• Phoenix Children's Hospital, Phoenix, United States

Pulmonary artery sling (PAS) is an uncommon congenital anomaly in which the left pulmonary artery (LPA) originates abnormally from the posterior aspect of the right pulmonary artery (RPA). The LPA then traverses between the trachea and esophagus, resulting in compression of the lower trachea. This compression can lead to respiratory symptoms, including wheezing and stridor, and in some cases, airway obstruction. In addition, bronchial compression—commonly affecting the right bronchus—can result in air trapping, pneumonia, and atelectasis. If left undiagnosed or untreated, these conditions may contribute to severe complications, including sudden death in neonates and infants [1]. The first successful surgical repair of PA sling was performed by Willis Potts and colleagues in 1953, who divided the LPA near its origin, repositioned it anteriorly to the trachea, and re-anastomosed it to the main pulmonary artery [2]. Although surgical techniques have remained largely unchanged, the approach has evolved to also address any concurrent tracheal or cardiac anomalies. In this report, we present postoperative rapid relief of a symptomatic case in which LPA transection and reimplantation to the main pulmonary artery were performed successfully on cardiopulmonary bypass.