Pulmonary Artery Sling with Tracheal Stenosis Combined with A Large Ventricular Septal Defect in A Two-Month-Old Boy: A Case Report

Pulmonary artery sling (PAS) is a rare congenital cardiovascular abnormality. In typical PAS patients, the left pulmonary artery (LPA) arises from the right pulmonary artery and passes between the trachea and esophagus, which possibly causes tracheal stenosis and some respiratory symptoms. PAS typically associates with other cardiovascular anomalies, which may cause difficulties to the treatment of patients. This report described a rare case of a two-month-old boy with PAS, VSD, and tracheal stenosis simultaneously and underwent procedures without tracheoplasty.

P.224 A Case Report of Spinal Screws Penetrating the Pulmonary Artery

Background: Spinal instrumentation is commonly utilized to mechanically stabilize the spine in trauma, oncology and degenerative disease. Although several complications have been reported, this is the first case of screw penetration of the pulmonary artery. Methods: We present a case of a 74-year old gentleman who suffered from a thoracic spine chordoma. He underwent a T8 resection with T8-T12 instrumented fusion with subsequent radiation. Recurrence of his disease led to resection of his 3rd and 4th ribs and repeat radiation. He presented 6 years later with 2 episodes of massive hemoptysis. Review of the literature was conducted to search for similar complications. Results: A Chest Computed Tomography scan demonstrated the presence of a pedicle screw tip in the right pulmonary artery. Angiogram revealed no evidence of active arterial extravasation. In the operating room, the patient had a right lower lobectomy, with segmental pulmonary artery sacrifice, as well as replacement of the spinal fixation hardware. Literature review revealed multiple aortic injuries following spinal instrumentation. However, this was the first case of pulmonary artery erosion. Conclusions: Spinal instrumentation has been associated with screw migration and penetration of nearby tissues and vessels. A high incidence of suspicion is required when patients present with delayed and unusual complications.

Anomalous Origin of the Right Pulmonary Artery From the Aorta and Congenital Tracheal Stenosis: Staged Repair in a Neonate

Anomalous origin of the right pulmonary artery from the ascending aorta (AORPA), sometimes referred to as hemitruncus, is a rare malformation. We report a unique case of AORPA associated with Ebstein's anomaly and with congenital tracheal stenosis due to complete tracheal rings. The AORPA and tracheal stenosis were both successfully corrected in the neonatal period.