PMC5385459_01
(A) 3D reconstruction of the great vessels based on a chest CT showing the diagnosis of pulmonary artery sling with aberrant origin of the left pulmonary artery (LPA) from the right pulmonary artery. (B) Echocardiography showing the main pulmonary artery, the right pulmonary artery and the LPA originating from the right pulmonary artery, as well as patent ductus arteriosus. (C) 3D reconstruction of the upper airways based on a chest CT showing long-segment tracheal stenosis beginning at the fifth tracheal ring and ending 5 mm above the carina.
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F1
The examinations revealed PAS associated with a PDA, an atrial septal defect, and a diffuse LSTS with eight complete cartilaginous rings extending from the fifth tracheal ring to five millimeters above the carina (Figure 1).
Intraoperative view of the trachea and the slide tracheoplasty procedure. A horizontal section of the stenotic trachea is performed (A), followed by vertical incisions of the proximal and distal parts (B), and finally elliptic anastomosis at the cut surface (C). With this procedure, the tracheal length is reduced by half.
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F2
After doing a median sternotomy and putting the child on cardiopulmonary bypass, ligation then section of the PDA and LPA reimplantation were performed followed by slide tracheoplasty (Figures 2 and 3).
Pre- and postoperative bronchoscopic views of the trachea. Before the surgical intervention, the trachea shows a significantly reduced tracheal lumen due to long-segment tracheal stenosis (A). After the slide tracheoplasty, the cross section of the tracheal lumen increases fourfold (B).
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F3
After doing a median sternotomy and putting the child on cardiopulmonary bypass, ligation then section of the PDA and LPA reimplantation were performed followed by slide tracheoplasty (Figures 2 and 3).
PMC5385459_02
Axial view of the pulmonary artery on angio-CT of the chest. The images show bilateral pulmonary artery thrombosis (arrows), with thromboses of the main pulmonary artery (A), of the upper branch of the right pulmonary artery (B), and of the upper (C) and lower branches of the left pulmonary artery (D).
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F4
CT scan revealed bilateral pulmonary artery thrombosis (Figure 4).
PMC5385459_03