Surgical Reconstruction of a Disconnected Left Pulmonary Artery Arising from the Left Subclavian Artery into Main Pulmonary Artery

Background: Anomalous origin of the left pulmonary artery (LPA) from the left subclavian artery is an exceptionally rare congenital vascular anomaly. Systemic arterial perfusion of the affected lung exposes it to elevated pressures, predisposing to pulmonary overcirculation, pulmonary hypertension, and early pulmonary vascular disease. Case Description: We report a child with anomalous origin of the LPA from the left subclavian artery who underwent successful surgical reimplantation of the LPA to the main pulmonary artery (MPA). The diagnosis was established using transthoracic echocardiography and computed tomography angiography. Definitive repair was performed via median sternotomy under cardiopulmonary bypass, achieving tension-free reimplantation of the LPA into the MPA. Results: The postoperative course was uneventful. Follow-up echocardiography demonstrated a widely patent LPA–MPA anastomosis with laminar flow, preserved ventricular function, and no evidence of pulmonary hypertension. Conclusion: Early diagnosis and surgical reimplantation of an anomalous LPA arising from the left subclavian artery can be performed safely with excellent early outcomes. This case contributes to the limited literature on this rare anomaly and supports early surgical intervention to prevent long-term pulmonary vascular complications.