Cemil KAYA, Bülent GÜZEL, Kenan YILMAZ, Ali YILDIRIM

Persistan Wheezing'in Nadir Bir Nedeni: Pulmoner Arter Sling

Giriş: Pulmoner arter sling sol pulmoner arterin sağ pulmoner arter arka kısmından köken aldığı vasküler bir patolojidir ve genellikle yaşamın ilk yılı içinde semptomlar ortaya çıkabilir. Olgu: Sekiz aylık erkek çocuk Çocuk Kardiyoloji Polikliniğine düzelmeyen hışıltı nedeniyle yönlendirildi. Hastanın hikâyesinden şikâyetlerinin doğumun birinci ayından itibaren mevcut olduğu öğrenildi. Hastada persistan wheezing tespit edilmesi nedeniyle kardiyak değerlendirme yapılması amacıyla tarafımıza sevk edildi. Hastanın kardiyak muayenesinde mezokardiyak odakta 4/6 pansistolik üfürümü mevcuttu. Ekokardiyografide ventriküler septal defekt, patent duktus arteriozus ve sol pulmoner arterinin sağ pulmoner arterden köken aldığı tespit edildi. Hastanın kontrastlı toraks tomografisinde sol pulmoner arterin sağ pulmoner arterden köken aldığı arkaya doğru ilerleyerek trakea ve özefagus arasından geçerek sol akciğer hilusuna ilerlediği tespit edildi. Trakeanın bu bölgede 3 mm'ye kadar daraldığı izlendi. Sonuç: Persistan wheezing ile başvuran hastalarda şikâyetlerin başlama zamanı ve karakteri iyi sorgulanmalı ve kardiyak de- ğerlendirme dikkatli bir şekilde yapılmalarak vasküler ring de- ğerlendirilmeli.

A Rare Cause of Persistent Wheezing: Pulmonary Artery Sling

Introduction: Pulmonary artery sling is created by anomalous origin of the left pulmonary artery from the posterior aspect of the right pulmonary artery. Symptoms usually occur within the first year of life Case: Eight-month-old boy was referred to pediatric cardiology department because of persistent wheezing. From the patient's anamnesis the complaints have been found since the first month of life. In order to be detected etiology of persistent wheezing, he was reffered to us due to cardiac evaluation. Pansystolic murmur found in the left lower sternal border on cardiac examination. It was found ventricular septal defect, patent ductus arteriosus and pulmonary artery sling on echocardiography. Chest CT was detected the left pulmonary artery arises right pulmonary artery and then courses behind the trachea and in front of esophagus. Trachea has narrowed up to 3 mm in this region. Conclusion: The character and onset time of complaints should be well questioned in patient with persistent wheezing and cardiac evaluation must be done carefully in these patients.

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