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Congenital Disorders of the Larynx, Trachea and Bronchi
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
A ‘pulmonary artery sling’ is produced by an anomalous left pulmonary artery, which arises on the right and passes between the trachea and oesophagus, compressing both (Figure 30.12). This may be associated with lower-end tracheal stenosis which sometimes also involves the carina and right main bronchus. Surgical reanastomosis may be needed to relieve the compression.
Disorders of larynx, trachea and upper airway
Published in Brice Antao, S Irish Michael, Anthony Lander, S Rothenberg MD Steven, Succeeding in Paediatric Surgery Examinations, 2017
Charles M Myer IV, Charles M Myer III
Complete tracheal rings exist when there is minimal to no trachealis muscle present in the posterior tracheal airway. This airway is less likely to grow commensurate with the patient and often presents during infancy. The condition is associated with various cardiovascular anomalies, most commonly a pulmonary artery sling. A three-dimensional contrast-enhanced chest CT scan will help elucidate any cardiovascular anomalies to be addressed at the time of tracheoplasty, since the majority of patients who require repair will need cardiopulmonary bypass. In addition, a CT scan complements bronchoscopic evaluation in determining the length and extent of tracheal stenosis.
Paediatric laryngeal disorders
Published in Declan Costello, Guri Sandhu, Practical Laryngology, 2015
Richard J. D. Hewitt, Benjamin E. J. Hartley, Thushitha Kunanandam
In the presence of a pulmonary artery sling, the normal left pulmonary artery is absent and an aberrant vessel arising from the right pulmonary artery surrounds the right bronchus passing between the trachea and oesophagus. Presentation is usually with a history of progressive breathing difficulties. MLB demonstrates anterior compression of the trachea, which may be subtle. The right main bronchus is narrowed. The lower half of the trachea is compressed from the right, laterally.
Comparative study between multi-detector computed tomography and echocardiography in evaluation of congenital vascular rings
Published in Alexandria Journal of Medicine, 2018
Manal Hamisa, Fatma Elsharawy, Wafaa Elsherbeny, Suzan Bayoumy
In our study there were two cases with left aortic arch and aberrant right subclavian and one case with pulmonary sling. Infants with pulmonary sling often complain with severe respiratory symptoms, In the study of Kagadis et al.26 reported that preoperative evaluation of trachea in a child with pulmonary artery sling using 3-D MDCT and bronchoscopy, showed that associated focal and extensive tracheal stenosis.
Pediatric bronchoscopy: recent advances and clinical challenges
Published in Expert Review of Respiratory Medicine, 2021
P Goussard, P Pohunek, E Eber, F Midulla, G Di Mattia, M Merven, JT Janson
The trachea will be compressed both anteriorly and posteriorly by a double aortic arch and only anteriorly in the case of the innominate artery. A left pulmonary artery sling causes compression of the distal trachea and the carina. Airways can also be compressed by congenital and acquired cardiac conditions and it is mostly the LMB that is vulnerable.