In persons with an anomalous or aberrant left pulmonary artery, the main pulmonary trunk rises normally from the right ventricle and passes upward and to the right of the trachea in the vicinity of the carina (Fig 1). At this point the aberrant left pulmonary artery branches off, passes between the trachea and esophagus, and enters the hilum of the left lung. During its course it compresses the trachea, esophagus, and the right main stem bronchus to a variable degree.
This anomaly has long been recognized in children 1-3 and has been associated with high morbidity and mortality.3 To our knowledge, the patient presented in this study is the first individual suffering from aberrant left pulmonary artery known to have survived until adult life without surgical treatment in childhood.
Our patient presented two particularly interesting features. (1) The aberrant artery was seen as a mediastinal mass on the plain