Loss of Left Lung Function Following Surgical Correction of Aberrant Left Pulmonary Artery

Abstract

To the Editor: Aberrant left pulmonary artery is an uncommon anomaly that is highly lethal when untreated. Its diagnosis is not difficult if the possibility is considered, and prompt surgery can prevent death. Therefore, Tesler and associates1Tesler UF Balsara RH Niguidula FN Aberrant left pulmonary artery (vascular sling): Report of five cases.Chest. 1974; 66: 402-407Crossref PubMed Scopus (18) Google Scholar have performed a valuable service in calling attention to this entity and adding their own five cases to the 67 already reported. Their review, however, omitted reference to a recently recognized major complication of corrective surgery for this lesion. Philp and coworkers in 19722Philp T Sumerling MD Fleming J et al.Aberrant left pulmonary artery.Clin Radiol. 1972; 23Google Scholar called attention to the high incidence of postoperative loss of blood flow in the reconstructed left pulmonary artery. We have recently completed a survey of the reported survivors of corrective operation, including three of our own cases; eight of the nine patients who have been studied postoperatively have been found to have obstruction of the left pulmonary artery.3Sade RM, Rosenthal A, Fellows K, et a1: Pulmonary artery sling. J Thorac Cardiovasc Surg (in press)Google Scholar Tesler's optimistic appraisal of the results of surgical treatment, therefore, probably is not justified; although patients appear normal and do well clinically after corrective operations, most have a nonfunctioning left lung. Loss of left pulmonary artery blood flow may not have long-term significance, but knowledge of its absence can be important, since one of our patients had a lethal complication at a later operation because of unrecognized absence of left lung function.