The authors report two cases of pulmonary artery sling diagnosed by three-dimensional reconstruction of images of the tracheobronchial tree and the esophagus acquired using magnetic resonance imaging or helical computer tomography. The typical clinical findings of this congenital abnormality, which may not be as rare as previously believed, include those related to severe tracheobronchial obstruction, although asymptomatic or mild symptomatic cases have been reported. Early diagnosis of this anomaly is extremely important, since in most cases immediate surgical correction is indicated due to its high lethality. The use of three-dimensional reconstruction allows simultaneous identification of the associated tracheobronchial and cardiovascular malformations, in addition to a clear visualization of the anomaly. Thus, the diagnosis can usually be established non-invasively, avoiding the use of the selective angiocardiography, considered the gold-standard.

Keywords: Pulmonary artery sling, Anomalous left pulmonary artery, Tracheal stenosis, Vascular ring, Left pulmonary artery variants