Pulmonary Artery Sling (Vascular Sling) Flashcards
(13 cards)
What is a left pulmonary artery (LPA) sling?
A congenital vascular anomaly where the LPA arises from the posterior aspect of the proximal right pulmonary artery (RPA)
How does the LPA course in an LPA sling?
The LPA courses over the right main bronchus and then posteriorly between the trachea and esophagus before reaching the left hilum
What unique characteristic does an LPA sling have?
It is the only vascular anomaly that results in a vascular structure lying between the trachea and esophagus
What condition can occur if a ductus arteriosus or ligamentum is patent in the presence of an LPA sling?
The LPA can become completely encircled around the trachea
What percentage of LPA slings are associated with tracheal stenosis, tracheobronchomalacia, or complete tracheal rings?
Upwards of 60%
What is the common term used to refer to the complex associated with LPA sling and tracheal stenosis?
“Ring-sling” complex
What percentage of LPA slings are associated with other congenital heart disease lesions?
40-60%
From which embryological structures do the distal branch pulmonary arteries arise?
Lung buds
What is suggested to cause the development of an LPA sling?
Regression or failure of the proximal left sixth aortic arch to develop normal connections to the left lung bud
What type of vessel develops from the RPA leading to an LPA sling?
A collateral vessel to the left lung
What diagnostic tool can be used solely to diagnose an LPA sling?
Echocardiogram
What imaging technique is often used to confirm the diagnosis of an LPA sling and assess for tracheal pathology?
CT scan
In which views is the evaluation of the branch pulmonary arteries for the presence of an LPA sling best established?
Suprasternal notch and parasternal short-axis views
