Evaluation of perioperative management of seven patients with pulmonary artery sling in recent seven years

Background : Pulmonary artery sling (PA sling) is a rare vascular anomaly in which the left pulmonary artery arises from the right pulmonary artery. It can cause compression of trachea. Due to its rarity, risk factors influencing postsurgical outcome are still unclear. The purpose of our study is to investigate past cases of PA sling to clarify risk factors. Methods : We investigated 7 patients who had undergone one-stage operation of PA sling from 2001 to 2007. Hospital stay, ICU stay and length of artificial ventilation are set as primary outcome. Patients' weight, range of tracheal stenosis, operation time, cardiopulmonary bypass time, presence of tracheal stenosis, bronchial anomaly, preoperative intubation, intracardiac anomaly and postoperative re-intubation were compared. Results : In-hospital mortality was none. Two cases in patients with tracheomalacia were re-intubated. Concomitant tracheoplasty was performed in six patients. Two patients with intracardiac anomaly underwent cardiac operation. No factor except tracheomalacia affected primary outcome. Conclusions : We need more cases to clarify factors affecting outcome of patients with PA sling. However, existence of tracheomalacia is found to be a risk factor of longer artificial ventilation.