Surgical reimplantation of the left pulmonary artery to the main pulmonary artery with concurrent slide tracheoplasty resulted in full recovery in an infant with left pulmonary artery sling causing significant tracheal compression.
Left pulmonary artery sling was identified as the cause of persistent stridor and recurrent respiratory distress in an infant presenting since birth.
Surgical reimplantation of the left pulmonary artery to the main pulmonary artery combined with concurrent slide tracheoplasty resulted in full recovery.
Early recognition of vascular anomalies is highlighted as important in infants presenting with unexplained airway obstruction.
This case report describes an infant who had noisy breathing (stridor) and repeated breathing difficulties from birth. Medical imaging revealed an unusual blood vessel arrangement called a left pulmonary artery sling, where the left pulmonary artery takes an abnormal path that wraps around and squeezes the windpipe (trachea), making it hard for the baby to breathe normally. The infant underwent surgery in which the misplaced artery was detached and reattached in its correct position, and a procedure called a slide tracheoplasty was performed at the same time to repair the compressed and narrowed section of the windpipe. Following these combined procedures, the infant made a full recovery. This research suggests that when babies have unexplained noisy or difficult breathing that starts at birth, doctors should consider the possibility of abnormal blood vessel arrangements as the underlying cause. Left pulmonary artery sling is a rare but serious condition that can be effectively treated with surgery when identified early, and this case illustrates the importance of using imaging to look for vascular causes of airway problems in infants.
Bizhga M, Saraci B. (2026). Left pulmonary artery sling in an infant: a vascular anomaly with a high impact on breathing.. BMJ case reports. https://doi.org/10.1136/bcr-2025-271605