Left pulmonary artery sling--anatomy and imaging.

Distinctive imaging findings are present when the left pulmonary artery (LPA) arises from the right pulmonary artery and forms a sling around the airway passing between airway and esophagus to reach the left lung. It is important to recognize the 2 distinct types of pulmonary sling. The less complex type I is associated with tracheobronchomalacia and is often managed successfully by LPA reimplantation. The more common and more complex type II is strongly associated with long segment tracheal stenosis. Appropriate management needs to address the airway abnormality in addition to the aberrant LPA. Both types, especially type II, are associated with cardiovascular, pulmonary, and other abnormalities that also need to be considered in therapeutic decisions. The role of imaging is to identify, define, and display the relevant anatomic relationships to facilitate appropriate management. Recent surgical advances have increased the likelihood of success of surgical correction of long segment airway stenosis. Copyright (c) 2010 Elsevier Inc. All rights reserved.