Extralobar sequestration with unusual arterial supply and venous drainage

Gamillscheg, Andreas; Beitzke, A; Smolle‐Jüttner, Freyja Maria; Zach, M; Stein, J.; Steinbrugger, B; Eber, Ernst; Litscher, H

doi:10.1007/bf02505815

Cited by 12 publications

(6 citation statements)

References 11 publications

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“…Atypical systemic venous drainage occurs less frequently than atypical arterial supply in congenital lung lesions, as the majority of intralobar BPS show normal venous drainage via pulmonary veins. Nevertheless, systemic venous drainage may also be found in IBPS ( 6 ). Supra-diaphragmatic systemic venous drainage in congenital lung lesions seems to be frequently connected to the azygos and less commonly to the hemiazygos system ( 4 , 7 – 9 ).…”

Section: Discussionmentioning

confidence: 99%

“…Supra-diaphragmatic systemic venous drainage in congenital lung lesions seems to be frequently connected to the azygos and less commonly to the hemiazygos system ( 4 , 7 – 9 ). Supra-diaphragmatic systemic venous return into the subclavian vein ( 6 ) and intercostal vein ( 9 ) has been described. Infra-diaphragmatic systemic venous drainage, as in one of our patients with EBPS, has been found via portal vein ( 9 , 14 – 17 ), inferior caval vein, splenic and suprarenal vein.…”

Section: Discussionmentioning

confidence: 99%

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Vascular Anatomy in Congenital Lung Lesions—Description and Classification

et al. 2022

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BackgroundBronchopulmonary sequestration (BPS) and hybrid lesion of congenital pulmonary airway malformation (CPAM) are congenital lung lesions typically presenting with systemic vascular connection. We describe and categorize this atypical systemic vascular anatomy in congenital lung lesions.MethodsIn a medical chart review from 2005 to 2020 patients with systemic vascular connection of congenital lung lesions were identified. Clinical and radiological data were collected and compared. Two experienced pediatric radiologists reviewed postnatal thoracic contrast-enhanced computed tomography scans to describe and categorize atypical vascular anatomy. We completed our findings with a review on vascular anatomy in congenital lung lesions.ResultsA total of 21 patients with congenital lung lesions (nine extralobar BPS, five intralobar BPS, seven hybrid lesions) had systemic arterial supply; with seven of these additionally having systemic venous drainage. Origin of the feeding arteries from the aorta or aortic main branches was described as supra-diaphragmatic (descending thoracic aorta) in nine and infra-diaphragmatic in ten patients (abdominal aorta, celiac trunk). In two patients with hybrid lesions both supra- and infra-diaphragmatic arterial feeders were found. Additional systemic venous connection of supra-diaphragmatic type drains into the azygos-hemiazygos system (4/21) while the infra-diaphragmatic type (3/21) drains into caval vein, portal or splenic vein.ConclusionVarious variants of systemic arterial and venous connection of congenital lung lesions can be found. Classification of systemic arterial connection as well as venous drainage of congenital lung lesions as supra-diaphragmatic and infra-diaphragmatic types is intuitive, simple and may be important for the surgeon to avoid unanticipated situations and to perform safe resections.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Vascular Anatomy in Congenital Lung Lesions—Description and Classification

et al. 2022

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“…However, Sauvanet and colleagues reported that the arteriography was diagnostic in only 28 of 40 cases [ 6 ]. Magnetic resonance angiography is useful in delineating the vascular anatomy of the sequestration [ 7 ]. Except arteriography, pulmonary angiography, magnetic resonance imaging; computed tomographic scanning, bronchography, and ultrasonographies have all been used in selected cases for preoperative diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Extralobar Pulmonary Sequestration With Anomalous Blood Supply From The Subclavian Artery

2004

IJTCVS

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Pulmonary sequestration is a rare embryonic mass of lung tissue that has no identifiable bronchial communication and that receives its blood supply from one or more anomalous systemic arteries. Systemic blood supply is commonly from the thoracic aorta. Venous drainage is commonly to systemic pulmonary vessels. A healthy, asymptomatic 20 year-old male was admitted to our hospital for evaluation of a left sided mass. The standard chest roentgenograms, a contrast-enhanced chest tomography, a bronchoscopic examination, thoracic magnetic resonance imaging and a selective angiography were performed. With these findings we decided that this heterogeneous lesion between mediastinum and left upper lobe as extralobar pulmonary sequestration. The patient underwent left sided posterolateral thoracotomy. We performed sequestrectomy. Postoperative period was uneventful.

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“…While the systemic collateral artery arises from the subclavian artery through the patent ductus arteriosus in patient 11, this may be the facsimile of the systemic pulmonary artery described by Cucci et al, 11 as in the cases of``absence of a primitive division of the pulmonary trunk'' due to defective septation of the truncus at Streeter Horizons XV±XVII (a 30±36-day embryo). 14,15 In the English-language literature, we found cases of pulmonary sequestration with systemic arterialization from the subclavian or intercostal artery, 16,17 which are similar in course to those of type III MAPCAs. Autopsy in patient 11 with isolated levocardia, bronchus inversus, visceroatrial inversus, common atrium, common atrioventricular valve, single ventricle, solitary outlet of the aorta, PDA, and pulmonary atresia showed a systemic feeding artery arising from the left subclavian artery via a PDA to the right lower lobe of the bilobed lung without bronchopulmonary airway sequestration.…”

Section: Cardiovascular Hypothesismentioning

confidence: 94%

Revisit on congenital bronchopulmonary vascular malformations: A haphazard branching theory of malinosculations and its clinical classification and implication

Lee¹,

Tsao²,

Chaou³

et al. 2001

Pediatric Pulmonology

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We propose a haphazard branching theory to support the concept of bronchopulmonary malinosculations, and we apply this theory to classify congenital bronchopulmonary vascular malformation (BPVM) based on the anatomical results we have found. Between January 1990 and December 1997, a total of 22 pediatric patients (10 male and 12 female), aged 2 days to 14 years (median, 19.6 months), with congenital BPVM were enrolled in this retrospective study. Study modalities include the clinical features and plain chest films (n = 22) plus at least two of the following: echocardiography (n = 13), barium esophagraphy (n = 2), bronchoscopy (n = 4), contrast bronchography (n = 8), high-resolution direct coronal CT (n = 1) and electron beam or ultrafast CT (n = 1) of the chest, MRI (n = 10), MRA (n = 1), contrast cineangiocardiography (n = 9), surgery (n = 11), or autopsy (n = 2). The salient clinical features were recurrent lung infections in 14 patients, acute respiratory distress in 13, associated cardiovascular malformations in 8, dextroversion in 7, congestive heart failure in 7, dextrocardia in 4, and complex congenital heart diseases in 4. There were abnormal openings (malinosculations) of the pulmonary airway in 20 patients: to an artery in 12, to a vein in 8, and to the lung parenchyma in 9. These 22 patients with congenital BPVM can be classified into bronchial malinosculation (10 cases), arterial malinosculation (2 cases), and bronchoarterial malinosculation (10 cases). Congenital BPVM can be classified in terms of bronchopulmonary malinosculation based upon a haphazard branching theory, in which abnormal communications between two independent systems (primitive foregut system and aortic-pulmonary arch system) occurred coincidentally rather than causally.

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Extralobar sequestration with unusual arterial supply and venous drainage

Cited by 12 publications

References 11 publications

Vascular Anatomy in Congenital Lung Lesions—Description and Classification

Vascular Anatomy in Congenital Lung Lesions—Description and Classification

Extralobar Pulmonary Sequestration With Anomalous Blood Supply From The Subclavian Artery

Revisit on congenital bronchopulmonary vascular malformations: A haphazard branching theory of malinosculations and its clinical classification and implication

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