Baxi, Ameya

The aim of this study was to investigate the features of partial anomalous left pulmonary artery (PALPA) and differences between cases with posterior versus anterior a nomalous vessels in relation to the tracheobronchial tree. We hypothesized that statistical significance was dependent on the course of the anomalous vessel due to airway compression in the posterior type. This study included cases obtained from the literature (n = 33) and an institution teaching file (n = 2). Information collected: age, sex, medical history, additional anomalies, anomalous vessel course, and respiratory symptoms. Data were analyzed with independent samples t-test and Fisher’s exact test. PALPAs were more commonly anterior than posterior. Mean age: 5.3 years (SD = 12.4) for anterior and 6.8 years (SD = 18.5) for posterior (p = 0.77). Respiratory symptoms: 20% of anterior and 60% of posterior cases (p = 0.032). Tracheobronchial anomalies: 35% of anterior and 60% of posterior cases (p = 0.182). Non-cardiac and non-tracheobronchial anomalies: 30% of anterior and 47% of posterior cases (p = 0.511). Kabuki syndrome: 25% of anterior and 6.7% of posterior cases (p = 0.207). In conclusion, respiratory symptoms were the only significant difference between anterior and posterior PALPA types.

Meandering pulmonary vein (MPV) is a rare entity that can be associated with an additional cardiac and pulmonary venous variations, including left-to-right shunts. Clinicians should consider further workup with dedicated cardiac imaging to evaluate for associated cardiovascular abnormalities after an abnormal pulmonary vein draining is initially identified on routine computed tomography or echocardiogram. Pulmonary venous variations in MPV represent a spectrum of disorders, and no consistent nomenclature has been established.