Left pulmonary artery sling (LPAS) derives its name from the aberrant course of the left pulmonary artery (asterisk in in Panel 1) that arises from the proximal right pulmonary artery, coursing over the right mainstem bronchus, posterior to the trachea (double S in Panel 1) and anterior to the esophagus (infinity sign in Panel 1) prior to reaching the left hilum, resembling a sling. This sling is reminiscent of the one used by David to defeat Goliath (arrows in Panel 2), represented in the magnificent sculpture by Giovan Lorenzo Bernini (the statue from different viewpoints in Panel 2). LAPS represents a very rare cause of large airway anatomical obstruction and its clinical manifestation relates to the severity of airway obstruction (Fig. 1).
A 55-year-old man with a mild cough and low fever underwent chest computed tomography that demonstrates an unknown LAPS (Panels 1 and 3) and bilateral pulmonary patchy ground-glass opacities consistent with COVID-19 infection (arrows in Panel 3), subsequently confirmed by reverse-transcriptase-polymerase-chain-reaction. The patient was cured, without needing to be hospitalized.
To the best of our knowledge, this is the first case of asymptomatic LAPS associated with the COVID-19 infection described in the literature. This case could prove that, in an asymptomatic patient with LAPS, this condition does not need a different approach to the COVID-19 infection than patients without such anatomical variant.
FundingNothing to declare.
