Pulmonary artery sling as a rare cause of dyspnoea of unknown origin

During a violation of the large arteries embryogenesis, a wide range of anomalies of the aortic arch and the vessels that depart from it, as well as the branches of the pulmonary artery with the formation of so-called vascular rings (VR), are possible. VR can partially or completely cover the trachea and esophagus and lead to their compression. Children with this pathology may be asymptomatic or, more often, they may have respiratory and/or esophageal symptoms, depending on the anatomy and degree of VR density. This abstract presents a clinical case-a child with an aberrant (retrotracheal) left pulmonary artery sling. Boy 14 mo with episodes of recurrent dry cough and expiratory stridor or wheezing started from first months of life. Several episodes were with fever and severe respiratory distress oxygen support and antibacterial treatment. During the echoCG no data were found for CHD, the aortic arch was visualized on the left side without an aberrant course of the vessels departing from the aortic arch. However, the anatomy of the branches of the pulmonary artery and the unusual course of its branches attracted attention (figure 1). The child was scheduled for a chest CT (results on figure 2) to make a differential diagnosis of respiratory disorders and suspicion of a vascular ring. After establishing the diagnosis, the child underwent a radical correction: plastic surgery of the left branch of the pulmonary artery. <bold>Conclusion:</bold> VR are quite rare pathology, therefore, there is little awareness of this pathology. Nevertheless, considering the serious consequences of this anomaly, VR should be included in the differential diagnosis list in children with stridor and/or airway obstruction.