Aberrant left pulmonary artery. Review of surgical results and report of a successfully treated case.

Aberrant left pulmonary artery is a rare anomaly which can cause severe respiratory distress by compressing the distal trachea. The most reliable diagnostic measures are barium swallow, which in most cases shows an anterior indentation of the oesophagus, and a pulmonary arteriogram to provide a conclusive diagnosis. Tomography of the trachea and the main bronchi should be performed, in order to detect possible additional malformations in the airways. In severely symptomatic cases, surgical correction should be done before a life-threatening situation has developed. The correction is best performed through a left thoracotomy, with transposition of the left pulmonary artery and end-to-side anastomosis to the main pulmonary artery. The postoperative course may be difficult, and the patient may require respirator support for two to three weeks. Early surgical revision must be considered if symptoms persist, if additional stenosis is demonstrated, or if malformations such as complete tracheal rings are observed in the area of compression at the time of the vascular correction.