Pulmonary Artery Sling with Bridge Bronchus in a Premature Infant: A Diagnostic and Management Challenge in Malaysia

Abstract

Pulmonary artery sling with bridge bronchus is a rare congenital vascular anomaly presenting significant diagnostic and management challenges, especially in resource-limited settings. This report details the case of a premature infant born at 34 weeks’ gestation, diagnosed with PA sling and bridge bronchus, compounded by severe tracheal stenosis and bronchopulmonary dysplasia. Despite intensive medical care, including ventilation and permissive hypercarbia, the infant remained critically ill, with recurrent desaturation episodes and hospital-acquired infections. Definitive surgical intervention was deferred due to low birth weight and resource limitations. The infant succumbed to death at day 50 of life. This case emphasizes the complex interplay of prematurity, congenital anomalies, and healthcare limitations in developing countries. Multidisciplinary approaches and targeted research are essential for improving outcomes in such challenging cases.