title: Abnormal cardiac axis as a prenatal marker of left pulmonary artery sling.
abstract: Left pulmonary artery sling (LPAS) is a rare vascular anomaly. The left pulmonary artery arises distally from the right pulmonary artery on the right side of the trachea and passes between the trachea and esophagus towards the left lung, compressing the lower trachea. LPAS is associated with congenital tracheal stenosis, which frequently requires early surgical intervention and has a poor prognosis due to severe airway obstruction after birth. Therefore, LPAS should be prenatally diagnosed to prepare for surgical intervention for tracheal stenosis. To the best of our knowledge, there are few reports on prenatal echocardiographic findings in LPAS. We report three prenatal cases of LPAS, which resulted in respiratory symptoms. We discuss fetal ultrasound findings and highlight the abnormal rotation of the fetal cardiac axis to the right as a useful sign in the prenatal screening of LPAS.
authors.affiliation: Department of Cardiology, Gunma Children's Medical Center, Gunma, Japan.|Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan.
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Ishii
authors.affiliation: Department of Cardiovascular Surgery, Gunma Children's Medical Center, Gunma, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Miyamoto
authors.affiliation: Department of Cardiology, Gunma Children's Medical Center, Gunma, Japan.
authors.forename: Kimiko
authors.initials: K
authors.lastname: Nakajima
authors.affiliation: Department of Cardiology, Gunma Children's Medical Center, Gunma, Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Department of Cardiology, Gunma Children's Medical Center, Gunma, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Ikeda
authors.affiliation: Department of Pediatric Cardiology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan.
authors.forename: Noboru
authors.initials: N
authors.lastname: Inamura
authors.affiliation: Department of Obstetrics, Gunma Children's Medical Center, Gunma, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Takagi
authors.affiliation: Department of Cardiology, Gunma Children's Medical Center, Gunma, Japan.
authors.forename: Tomio
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Arakawa
mesh_terms: D000328:Adult; D004452:Echocardiography; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011651:Pulmonary Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging; D014135:Tracheal Stenosis / Q000209:etiology*; D016216:Ultrasonography, Prenatal / Q000379:methods*; D054079:Vascular Malformations / Q000150:complications / Q000175:diagnosis*
keywords: congenital tracheal stenosis; echocardiography; left pulmonary artery sling; prenatal screening; pulmonary artery