The child, female, 5 months, was admitted to the PICU of Yuexiu Hospital on 2014-12-07 at 4:00 pm with “shortness of breath and wheezing for 1 day”, on admission the child was moaning and breathing with shortness of breath and effort, positive trigeminal sign, inspiratory dyspnea, irritability, perilabial cyanosis, rapid increase in heart rate to 180 beats/min, sweating profusely, auscultation A large number of wheezing sounds could be detected in both lungs, oxygen saturation decreased, so tracheal intubation ventilator assisted breathing was performed, chest X-ray suggested right pneumothorax, inflammation of both lungs, chest CT suggested bronchial bridge lesion, considering pulmonary artery sling suggested cardiac CTA examination; cardiac CT suggested: vagal left pulmonary artery, bronchial bridge variation, mid left main bronchus stenosis between true and false bulge (due to vascular ring); right middle and lower pulmonary atelectasis. Cardiac ultrasound: left pulmonary artery originated from the right pulmonary artery (images below): The child underwent correction of the abnormal origin of the left pulmonary artery + tracheoplasty on 2014-12-11. Intraoperatively, the left pulmonary artery was seen to originate from the posterior wall of the right pulmonary artery, in front of the proximal end of the right main bronchus, entering the left hilum between the lower trachea and the esophagus, causing stenosis of the lower trachea, the rongeur and the right and left main bronchus, with a length of approximately 62.5 px. The right upper bronchus alone originated from the right posterior wall of the trachea, about 37.5 px from the true rongeur, and the opening could be passed by a 3# probe. The left pulmonary artery was lifted to the left side between the bronchus and esophagus, the lower tracheal stenosis was resected, the trachea was dissected longitudinally, and the right and left main bronchial openings and the right upper pulmonary bronchus were augmentoplasty. Early review of the chest radiograph indicated right upper lung atelectasis with obvious exudation in both lungs (Figure 3), ventilator assisted breathing, airway pressure 28-34 mbar, treatment with imipenem to fight infection, propecia to enhance immunity, hormone anti-inflammatory, keeping the neck in forward bending position, and pulmonary body therapy. The right upper lung bronchial opening was obstructed by sputum, and alveolar lavage was performed; after treatment, the chest X-ray was reviewed and the ventilator was successfully withdrawn 14 days after surgery, as shown in Figure 4. The child was discharged from the hospital 20 days after the operation without coughing, wheezing and other discomforts. No respiratory symptoms such as shortness of breath and recurrent cough for 1 month out of hospital, and good general condition.