Document Detail


Combined left pulmonary artery sling transposition and tracheal lobe resection through a median sternotomy: a case report.
MedLine Citation:
PMID:  20333884     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: The aim of this paper was to report the management of a very rare malformative association of Left Pulmonary Artery (LPA) sling and Tracheal Lobe which is not still reported in scientific literature. MATERIALS AND METHODS: The Authors describe the clinical case of a 6 years old girl that was admitted for chronic respiratory symptoms associated with recurrent upper respiratory infections. The CT-scan with virtual bronchoscopy showed an ectopic bronchus arising from the right side of the upper third of the trachea and ending in an accessory pulmonary lobe, covered by normal pleura, located in the upper mediastinum. The tracheo-broncoscopy showed a stenotic tracheal lumen with complete cartilaginous ring with an evident vascular pulsation in the middle of stenotic tract. An angio-CT confirmed the vascular anomalies with the LPA which passes between the lower trachea and the accessory tracheal bronchus and the coexistence of a persistent left superior vena cava. The surgical approach, after the thoracoscopic exploration, was a double procedure through a median sternotomy with cardiopulmonary bypass has permitted to excise completely the tracheal lobe and to reimplant the left pulmonary artery into the main pulmonary artery. RESULTS: No more upper respiratory symptoms or pulmonary infections have been observed during the clinical and instrumental follow up. CONCLUSIONS: Current controversy in the management of Pulmonary Artery sling include surgical approach (median sternotomy versus left thoracotomy), use or non-use of cardiopulmonary bypass, and reimplantation versus translocation with distal tracheal resection. In our experience LPA reimplantation and tracheal lobe resection have been made easily and safely by the same sternotomy utilized for the cardio-pulmonary by-pass.
Authors:
M Lima; A Ratta; G D Gargiulo; S Baroncini; T Gargano; B Randi
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  La Pediatria medica e chirurgica : Medical and surgical pediatrics     Volume:  31     ISSN:  0391-5387     ISO Abbreviation:  Pediatr Med Chir     Publication Date:    2009 Nov-Dec
Date Detail:
Created Date:  2010-03-25     Completed Date:  2010-04-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8100625     Medline TA:  Pediatr Med Chir     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  252-7     Citation Subset:  IM    
Affiliation:
Department of Paediatric Surgery, Bologna University, Italy. m.lima@med.unibo.it
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MeSH Terms
Descriptor/Qualifier:
Angiography
Bronchi / abnormalities*
Child
Congenital Abnormalities / diagnosis,  radiography,  surgery*
Female
Follow-Up Studies
Humans
Pulmonary Artery / abnormalities*
Radiography, Thoracic
Sternotomy*
Time Factors
Tomography, X-Ray Computed
Tracheal Stenosis / congenital*,  surgery
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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