Aberrant left pulmonary artery or pulmonary artery sling is characterized by anomalous origin of the left PA from the right PA and passes between trachea and esophagus. It causes compression of the trachea and right mainstem bronchus, causing upper airway symptoms. These patients require a full work-up, including imaging and surgery planning.

In our case, only the lower lobe branch of the left PA has an anomalous origin. It originates below the level of the right lower lobe bronchus and is located between the left main bronchus and the esophagus, without compressing them. 

The patient underwent surgery to repair the VSD. It was decided to monitor the condition of the pulmonary arteries.