Clinical Characteristics Diagnosis Treatment And Prognosis Of Pulmonary Artery Sling In Thirty-eight Cases

Objective: To explore the clinical characteristics, diagnosis,treatment and prognosis of pulmonary artery sling(PAS).Methods : To retrospectively analyze the clinical data of 38 PAS patients who were hospitalized in Children’s Hospital, Chongqing Medical University between June 2009 to February 2015. Analyzed the risk factors of LPA reimplantation.Results : In 38 cases, there were 35 cases(92.11%) presented with clinical symptoms before 1 year old, and 6 cases(15.79%) before 1month old. 5 cases presented with clinical symptoms at birth. 30 cases(78.95%) were confirmed to have PAS before 1 year old. In 38 cases, 35cases(89.47%) were admitted to hospital because of respiratory manifestations such as repeated cough(34/38, 89.47%), wheeze(32/38,84.21%). 3 cases were diagnosed with PAS as routine preoperative examination. 38 cases were performed multi-slice spiral CT angiography(CTA) examination, and 37 of theses cases were diagnosed as PAS. CTA diagnostic rate was 97.37%. 27 of theses cases were found the LPA wasfrom the right pulmonary artery sling with 75% diagnostic rate. Treatment and prognosis: 25 PAS children underwent left pulmonary artery(LPA)reimplantation. 7 cases died and 18 cases survived. PAS associated with complete tracheal rings was found more in the deaths group(P<0.05).While there were 9 deaths and 3 survivors in non-surgical group(12cases).Conclusions : PAS presents with clinical symptoms in early age.Repeated cough and wheeze are the most common clinical manifestations of PAS. The echocardiography is valuable for early diagnosis of PAS, but CTA is the best examination. The LPA reimplantation is an important management to remove oppression. Complete tracheal rings may be risk factor for LPA reimplantation.