Abstract: Objective To explore the diagnosis and surgical treatment of pulmonary artery(PA)sling complicated with tracheal stenosis. Methods Clinical data of 23 cases of PA sling complicated with tracheal stenosis treated in our hospital during Jan. 2012 and Jan. 2016 were retrospectively analyzed. The patients were divided into mild stenosis group(n=13, MS group)and severe stenosis group(n=13, SS group)according to the extent of tracheal stenosis. The clinical features, surgical techniques and the treatment outcomes were reviewed. Results Altogether 9 patients(69%)in MS group had no obvious respiratory symptoms while all patients in SS group had obvious symptoms. Patients in MS group received left pulmonary artery(LPA)re-implantation alone. In SS group, patients with complete tracheal cartilage ring who had with stridor at rest underwent LPA re-implantation together with resection of narrowed segment and direct reanastomosis, 1 patient with tracheomalacia had tracheal stent placed, and the other patients received LPA re-implantation alone. All patients in MS group recovered smoothly. In SS group, 1 patient with complete tracheal ring and tracheomalacia who received LPA re-implantation without tracheal intervention failed to extubate after surgery and finally died of multiple organ failure; 3 patients who received LPA re-implantation and tracheoplasty simultaneously had an uneventful postoperative course, the patient with tracheal stent had excessive secretions in respiratory tract, received bronchoscopy repeatedly to clear sputum, and died 1 month later because of fatal bleeding from a tracheal stent suddenly; 2 patients required non-invasive continuous positive airway pressure(CPAP)to relieve respiratory distress after 山 东 大 学 学 报 (医 学 版)55卷8期 -冯致余,等.肺动脉吊带合并气管狭窄的外科治疗 \=-extubation. During the follow-up of 5 to 53 months, all patients in MS group were free of respiratory symptoms; 2 patients in SS group showed tachypnea during exercise; the respiratory symptoms were relieved during 5 to 11 months after surgery. Conclusion PA Sling complicated with tracheal stenosis has no specific symptoms and care should be taken to avoid misdiagnosis. Preoperative fiber optic bronchoscopy intervention contributes to evaluate the location, type and degree of lumen stenosis exactly. Moreover, selection of surgical approach depends on the severity and type of stenosis in tracheal lumen and preoperative respiratory symptoms.

Key words: Cardiovascular abnormalities, Trachea, Treatment outcome, Surgery, Diagnosis