Complete cartilage-ring tracheal stenosis associated with anomalous left pulmonary artery: the ring-sling complex.

Abstract

The persistent high mortality in infants with pulmonary artery sling (retrotracheal anomalous left pulmonary artery) is primarily due to the coexistence in such patients of long-segment tracheal stenosis due to complete cartilage rings. Five such patients are reported. Airway studies (by filtered high-kV radiography, bronchography and/or CT [computed tomography]) showed low carina, horizontal equal-length right and left mainstem bronchi and long-segment tracheal stenosis. The length of the stenosis far exceeded the contact with the pulmonary sling. The suggested term ring-sling complex for such patients correctly places emphasis on detection of the tracheal malformation, which currently has no satisfactory surgical treatment.