Double trouble: fetal diagnosis of a pulmonary artery sling and vascular ring

Lee, Jesse W.; Printz, Beth F.; Hegde, Sanjeet; Vargas, Lisa A.; Sun, Heather Y.

doi:10.1002/ccr3.733

Cited by 11 publications

(19 citation statements)

References 8 publications

(11 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The coexistence of a PAS, right AA, and aberrant left subclavian artery in cases with two overlapping, or double vascular rings, has been previously reported 9 . There are no previous reports of patients with concurrent DAA and PAS as seen in our patient.…”

Section: Discussionsupporting

confidence: 64%

Double vascular ring: a case report of double aortic arch and concurrent pulmonary artery sling

Matsumoto

Kamada

Nakagawa

et al. 2019

European Heart Journal - Case Reports

View full text Add to dashboard Cite

Background Double aortic arch (DAA) and pulmonary artery sling (PAS) are vascular ring formations that present in neonates and infants with symptoms of respiratory stenosis. Case summary The patient was a girl with suspected ventricular septal defect (VSD), right aortic arch (AA), left patent ductus arteriosus, and bilateral superior vena cava (SVC) on foetal echography in the first day of life. The girl was delivered at 40 weeks and 4 days of gestation. Ventricular septal defect, DAA, coarctation of the left AA, and bilateral SVC were diagnosed. Contrast-enhanced computed tomography at Day 16 revealed PAS with concurrent anomalous tracheal branching in addition to DAA. The right A2 segmental artery, which supplies the right upper pulmonary artery, showed abnormal branching from the left pulmonary artery (LPA). At 3 months of age, VSD patching, left AA resection distal to the root of the left subclavian artery, arterial ligament dissection, and LPA replacement were performed. Discussion Pulmonary artery sling coexists with anomalous branching of the trachea and abnormal branching of the right pulmonary artery (RPA). Our patient had an extremely rare case of DAA concurrent with PAS and presented with anomalous tracheal and RPA branching. We were concerned that increased pulmonary blood flow caused by the VSD would exacerbate tracheal displacement. Radical surgery at 3 months of age resulted in good postoperative progress.

show abstract

Section: Discussionsupporting

confidence: 64%

Double vascular ring: a case report of double aortic arch and concurrent pulmonary artery sling

Matsumoto

Kamada

Nakagawa

et al. 2019

European Heart Journal - Case Reports

View full text Add to dashboard Cite

show abstract

“…3,[5][6][7][8] Only three out of thirteen cases are isolated and have no cardiac and extra cardiac findings on fetal echocardiography examination. 6,7,9,10 In to the right side due to the right lung hypoplasia (Table 1) The features of our case were that there were not any cardiac or extra cardiac abnormalities, and the LPAS was isolated. 6,7,9,10 In to the right side due to the right lung hypoplasia (Table 1) The features of our case were that there were not any cardiac or extra cardiac abnormalities, and the LPAS was isolated.…”

Section: Discussion and Con Clus I Onmentioning

confidence: 68%

Prenatal diagnosis of left pulmonary artery sling and review of literature

et al. 2019

View full text Add to dashboard Cite

Left pulmonary artery sling (LPAS) is a very rare cause of large airway compression. In LPAS, the left pulmonary artery (LPA) arises from the proximal right pulmonary artery, coursing over the right mainstem bronchus, posterior to the trachea and anterior to the esophagus prior to reaching the left hilum. The aberrant course of the LPA results in anatomical obstruction of the right mainstem bronchus, the trachea, or both. Thirty percent of affected patients have major associated structural heart disease 1 which can importantly impact clinical outcome. 2 The clinical manifestation of LPAS after birth usually relates to the severity of airway obstruction and the associated cardiac pathology. Only a few reports present the prenatal features of LPAS. In the present report, we present the prenatal diagnosis of a case of LPAS in one of a set of identical twins in which the only feature was that of an abnormal course of the LPA on 3-vessel tracheal view. | C A S E PRE S ENTATI ONA 30-year-old primigravida woman at 27 weeks' gestation was referred to our maternal fetal medicine unit given the presence of a set of monochorionic, diamniotic spontaneous twins. A full anatomical ultrasound examination performed in both fetuses demonstrated no pathology, and fetal echocardiography demonstrated no major structural heart disease in one twin. In the other twin, fetal echocardiography revealed on a 3-vessel tracheal view that the LPA originated from the right pulmonary artery, originating initially to the right side of the trachea, and turning sharply to course between the trachea and esophagus prior to joining the left hilum (Figure 1, Movie S1). The examination was performed transabdominally using a Voluson E 6 (GE healthcare Ultrasound, Milwaukee, WI, USA) ultrasound machine equipped with a RAB 6D (2-7 MHz) probe. With these findings, pediatric cardiology counseling was offered and LPAS was suspected. The remainder of the cardiac anatomy was Left pulmonary artery sling (LPAS) is a very rare cause of large airway compression.In LPAS, the left pulmonary artery (LPA) arises from the proximal right pulmonary artery, coursing over the right mainstem bronchus, posterior to the trachea and anterior to the esophagus prior to reaching the left hilum. The aberrant course of the LPA results in anatomical obstruction of the right mainstem bronchus, the trachea, or both. Only a few reports present the prenatal features of LPAS. In this report, we present the prenatal diagnosis of a case of LPAS in one of a set of identical twins in which the only feature was that of an abnormal course of the LPA on 3-vessel tracheal view. The cross-sectional view at the level of three vessels which includes both pulmonary artery branches is useful to detect this abnormality. Color and power Doppler may be helpful as well. K E Y W O R D Sfetal echocardiography, left pulmonary artery, vascular imaging

show abstract

“…The presence of a right aortic arch and an aberrant left subclavian artery are the results of disappearance of the left fourth aortic arch, persistence of the right fourth aortic arch, which becomes the right arch, and loss of the left sixth aortic arch, except for the ductus arteriosus. 1 When the aforementioned developmental processes occur simultaneously, a pulmonary sling and a vascular ring may coexist. In all, 50-65% of left pulmonary artery slings are associated with complete tracheal rings, and of these 70-80% are associated with tracheal stenosis.…”

Section: Case Reportmentioning

confidence: 99%

“…The presence of both lesions in the same setting is extremely rare and, to our knowledge, has been reported in only one case in literature. 1 We present a case of a toddler who was diagnosed with a left pulmonary artery sling and a vascular ring as part of the screening process for the VACTERL associationco-occurrence of vertebral, anorectal, cardiac, tracheoesophageal, renal, and limb malformations.…”

Section: Introductionmentioning

confidence: 99%

A pulmonary artery sling with a vascular ring in a toddler: an uncommon combination

2018

View full text Add to dashboard Cite

Pulmonary artery slings and vascular rings are very rare congenital anomalies. It is even rarer to have both anomalies in the same setting. We present a case of a toddler who was diagnosed with a left pulmonary artery sling and a vascular ring as part of the screening process for the VACTERL association - co-occurrence of vertebral, anorectal, cardiac, tracheoesophageal, renal, and limb malformations. He underwent a successful surgical repair via median sternotomy and on cardiopulmonary bypass with an uneventful postoperative course.

show abstract

Double trouble: fetal diagnosis of a pulmonary artery sling and vascular ring

Cited by 11 publications

References 8 publications

Double vascular ring: a case report of double aortic arch and concurrent pulmonary artery sling

Double vascular ring: a case report of double aortic arch and concurrent pulmonary artery sling

Prenatal diagnosis of left pulmonary artery sling and review of literature

A pulmonary artery sling with a vascular ring in a toddler: an uncommon combination

Contact Info

Product

Resources

About