Aberrant left pulmonary artery (pulmonary artery sling): Successful repair and 24 year follow-up report

A case of anomalous left pulmonary artery arising from the right and coursing behind the trachea and anterior to the esophagus (pulmonary artery sling) is reported. The therapy currently advocated for this disorder is ligation of the anomalous vessel and performance of a left pulmonary to main pulmonary arterial anastomosis anterior to the trachea. A median sternotomy incision allows total mobilization of the anomalous vessel, minimizes respiratory embarrassment and aids in performance of the anastomosis. In the present case, a postoperative pulmonary angiogram revealed a patent left pulmonary artery, the second reported instance of such patency. The first successful repair of pulmonary artery sling was reported by Potts and colleagues in 1954. After a 24 year follow-up period their patient has normal exercise tolerance and no perfusion to the left lung is evident on ventilation-perfusion scan.