A rare case of congenital anomalous/aberrant systemic artery to pulmonary venous fistula in a 4-month-old child with co-existent mitral valve prolapse and mitral regurgitation

Abstract

DESCRIPTIONWe present a rare case of descending aorta pulmonary venous fistula (DAPVF) in a 4-month-old child with mitral valve prolapse who was being evaluated for failure to thrive. Echocardiogram revealed abnormal turbulence in the left atrial appendage and mitral valve prolapse with mitral regurgitation (to a mild degree). Low dose non-ECG-gated cardiac CT (two postcontrast phases) and CT of the thorax (80 kVp, 50 mAs with automated tube current modulation) were performed using a Philips Brilliance 64-slice MDCT machine. An abnormal dilated artery arising from the descending thoracic aorta at the D7-D8 level on the left, giving rise to a nidus of tortuous vessels in the superior segment of the left lower lobe (figures 1-4) and draining into the left inferior pulmonary vein resulting in a left to left shunt was noted (figure 5).

Left extralobar pulmonary sequestration and a right aorto-to-pulmonary vein fistula in a newborn: a 3-mm thoracoscopic monolateral approach

“…In the presence of a distinct pleural covering and a complete anatomical separation of the mass from adjacent normal lung tissue, the sequestration is defined as extralobar and is usually managed by resection. An aorta-to-pulmonary vein fistula without sequestration can be managed by surgical ligation or percutaneous closure of the fistula [4]. In recent years, thoracoscopy has emerged as an established technique for the management of congenital pulmonary malformations in infancy [5] and has also been proven to be a safe and effective procedure in the treatment of this rare and complex congenital malformation.…”