Pulmonary Artery Sling Clinical Presentation

  • Author: Stuart Berger, MD; Chief Editor: Steven R Neish, MD, SM   more...
 
Updated: Jan 19, 2012
 

History

In patients with pulmonary artery sling, the history is predictable and usually not subtle. Most infants are affected within the first few weeks of life and present with stridor, respiratory distress, cyanosis, wheezing, and/or pneumonia.

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Physical

Physical examination demonstrates respiratory distress with stridor, dyspnea, and wheezing. When tracheal obstruction is present, the infant may have constant retractions and tachypnea. If a congenital heart defect is associated, its typical physical findings can be identified.

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Causes

The specific etiology of the pulmonary artery sling is unknown.

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Contributor Information and Disclosures
Author

Stuart Berger, MD  Professor of Pediatrics, Division of Cardiology, Medical College of Wisconsin; Chief of Pediatric Cardiology, Medical Director of Pediatric Heart Transplant Program, Medical Director of The Heart Center, Children's Hospital of Wisconsin

Stuart Berger, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Cardiology, American College of Chest Physicians, American Heart Association, and Society for Cardiac Angiography and Interventions

Disclosure: Nothing to disclose.

Specialty Editor Board

Ira H Gessner, MD  Professor Emeritus, Pediatric Cardiology, University of Florida College of Medicine

Ira H Gessner, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Cardiology, American Heart Association, American Pediatric Society, and Society for Pediatric Research

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Hugh D Allen, MD  Professor, Department of Pediatrics, Division of Pediatric Cardiology and Department of Internal Medicine, Ohio State University College of Medicine

Hugh D Allen, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Cardiology, American Heart Association, American Pediatric Society, American Society of Echocardiography, Society for Pediatric Research, Society of Pediatric Echocardiography, and Western Society for Pediatric Research

Disclosure: Nothing to disclose.

Gilbert Z Herzberg, MD  Assistant Professor, Department of Pediatrics, Section of Pediatric Cardiology, New York Medical College; Consulting Staff, Department of Pediatrics, Sound Shore Medical Center

Gilbert Z Herzberg, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Chief Editor

Steven R Neish, MD, SM  Director of Pediatric Cardiology Fellowship Program, Associate Professor, Department of Pediatrics, Baylor College of Medicine

Steven R Neish, MD, SM is a member of the following medical societies: American Academy of Pediatrics, American College of Cardiology, and American Heart Association

Disclosure: Nothing to disclose.

References

  1. Sade RM, Rosenthal A, Fellows K, et al. Pulmonary artery sling. J Thorac Cardiovasc Surg. Mar 1975;69(3):333-46. [Medline].

  2. Loukanov T, Sebening C, Springer W, et al. Simultaneous management of congenital tracheal stenosis and cardiac anomalies in infants. J Thorac Cardiovasc Surg. Dec 2005;130(6):1537-41. [Medline].

  3. Newman B, Cho YA. Left Pulmonary Artery Sling-Anatomy and Imaging. Semin Ultrasound CT MR. Apr 2010;31(2):158-170. [Medline].

  4. Potts W, Holinger P. Anomalous left pulmonary artery causing obstruction to the right main stem bronchus. JAMA. 1954;155:1409.

  5. Backer CL, Russell HM, Kaushal S, Rastatter JC, Rigsby CK, Holinger LD. Pulmonary artery sling: Current results with cardiopulmonary bypass. J Thorac Cardiovasc Surg. Jan 2012;143(1):144-51. [Medline].

  6. Freedom R, Culham J. The Angiography of Congenital Heart Disease. 1998.

  7. Grover FL, Norton JB Jr, Webb GE, et al. Pulmonary sling. Case report and collective review. J Thorac Cardiovasc Surg. Feb 1975;69(2):295-300. [Medline].

  8. Morrow R, Huhta J. Aortic arch and pulmonary artery anomalies. In: The Science and Practice of Pediatric Cardiology. 1990:1444-7.

  9. Niwayama G. Unusual vascular ring formed by the anomalous left pulmonary artery, with tracheal compression. Am Heart J. Mar 1960;59:454-61. [Medline].

  10. Semple MG, Bricker L, Shaw BN, Pilling DW. Left pulmonary artery sling presenting as unilateral echogenic lung on 20-week detailed antenatal ultrasound examination. Pediatr Radiol. Aug 2003;33(8):567-9. [Medline].

  11. Tesler UF, Balsara RH, Niguidula FN. Aberrant left pulmonary artery (vascular sling): report of five cases. Chest. Oct 1974;66(4):402-7. [Medline].

 
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Aberrant left pulmonary artery or pulmonary artery sling.
 
 
 
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