Coexistence of left pulmonary artery sling and aortopulmonary window complicated with difficult airway-a rare congenital cardiopulmonary defect

• Published in: European journal of cardio-thoracic surgery Vol. 28; no. 6; pp. 900 - 902
• Main Authors: Chen, Huai-Min, Tseng, Hsin-I, Huang, Jiann-Wei, Dai, Zen-Kong
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Science B.V 01.12.2005; Elsevier Science
• Subjects: Abnormalities, Multiple - diagnostic imaging; Abnormalities, Multiple - surgery; Aortopulmonary Septal Defect - diagnostic imaging; Aortopulmonary Septal Defect - surgery; Biological and medical sciences; Bronchial Spasm - etiology; Cardiology. Vascular system; Chronic obstructive pulmonary disease, asthma; Humans; Infant, Newborn; Male; Medical sciences; Pneumology; Postoperative Complications; Pulmonary Artery - abnormalities; Pulmonary Artery - diagnostic imaging; Pulmonary Artery - surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Tomography, X-Ray Computed; Tracheal Diseases - complications; Bronchospasm; Tracheomalacia; Aortopulmonary window; Vascular airway compression; Left pulmonary artery sling; Diseases of the trachea; Compression; Congenital; Image processing; Respiratory disease; Cardiopulmonary; Windows; Phlebology; Blood vessel; Bronchus disease; Complication; Aortopulmonary; Circulatory system; Cardiology; Left pulmonary artery
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/j.ejcts.2005.08.024

Both the pulmonary artery sling and the aortopulmonary window are unusual and serious anomalies. In patients with sling the airway might be compromised by associated cartilaginous o-rings in variant segments. In aortopulmonary window the clinical presentations are similar to the large patent ductus arteriosus or ventricular septal defect, but the surgical procedure is quite difficult and different. We operated an infant with a rarely seen cardiac defect, the coexistence of left pulmonary artery sling and Type 3 aortopulmonary window, when he was 35 days old. Postoperative repeated bronchospasm caused prolonged ventilation and hospitalization. Patient was extubated 28 days later and discharged at the age of 80 days without any events. Besides, the reconstructed three-dimensional images of ultrafast computed tomography offered us an interesting view other than surgical findings. A case of two such rare lesions coexisting was not to be found in the literature review, so we report this case because of its rarity and clinical interest.