Pulmonary Artery Sling in an Asymptomatic 15-Year-Old Boy

Imperforate anus, diaphragmatic hernia, horseshoe kidney, and pulmonary sling complex: case description

“…Our patient was completely asymptomatic until after his surgery at 4 months of age, and this delayed the diagnosis of the pulmonary sling complex. This is not unusual because pulmonary slings may be asymptomatic even into the teenage years [16]. Cardiovascular anomalies are found in approximately 50% of patients with pulmonary artery sling and include persistent left superior vena cava, atrial septal defect, ventricular septal defect, and aortic arch anomalies [12].…”

Left pulmonary artery sling without symptoms

“…[1] However, the true incidence of asymptomatic vascular sling is not known, and surgical intervention may not be warranted unless asymmetric lung perfusion worsens on long-term follow-up. [2] Significant tracheobronchomalacia is unlikely without respiratory symptoms in the presence of normal awake airway imaging.…”

Cervical left pulmonary artery

“…There are other less likely mechanisms that warrant consideration. As previously noted, the most common LPA abnormality seen is the PAS, in which the LPA originates from the posterior aspect of the RPA, encircles the right mainstem bronchus, and then passes between the esophagus and trachea as it courses to the left lung [ 4 ]. Since our patient’s LPA had a similar origin from the posterior RPA, the two main hypotheses by Jue et al and Sade et al [ 5 , 6 ], which explain the formation of PAS should be considered.…”