After receiving a neonatal right pneumonectomy for septic complications of unilateral pulmonary artery agenesis, a 2 1/2 -year-old girl was referred to the Cardiothoracic Surgery Service for evaluation of increasing symptoms of wheezing and stridor. Extensive workup included a three-dimensional ultrafast CT image reconstruction that aided in the diagnosis and operative planning. Successful relief of the airway obstruction was achieved by aortic suspension and by placing a Silastic tissue expander prosthesis. Before operation, this child had been admitted to the hospital on 18 different occasions for respiratory symptoms. Six months after surgery, she is not receiving any medications and is symptom free.