Arterial supply of an intralobar pulmonary sequestration(IPS) from the coronary circulation is extremely rare. A significant coronary steal does not occur because of dual or triple sources of blood supply to sequestra...Arterial supply of an intralobar pulmonary sequestration(IPS) from the coronary circulation is extremely rare. A significant coronary steal does not occur because of dual or triple sources of blood supply to sequestrated lung tissue. We present a 60-year-old woman who presented to us with repeated episodes of monomorphic ventricular tachycardia(VT) in last 3 mo. Radio frequency ablation was ineffective. On evaluation, she had right lower lobe IPS with dual arterial blood supply, i.e., right pulmonary artery and the systemic arterial supply from the right coronary artery(RCA). Stress myocardial perfusion scan revealed significant inducible ischemia in the RCA territory. Coronary angiogram revealed critical stenosis of proximal RCA just after the origin of the systemic artery supplying IPS. The critical stenosis in the RCA was stented. At 12 mo follow-up, she had no further episodes of VT or angina.展开更多
BACKGROUND Pulmonary sequestrations often lead to serious complications such as infections,tuberculosis,fatal hemoptysis,cardiovascular problems,and even malignant degeneration,but it is rarely documented with medium ...BACKGROUND Pulmonary sequestrations often lead to serious complications such as infections,tuberculosis,fatal hemoptysis,cardiovascular problems,and even malignant degeneration,but it is rarely documented with medium and large vessel vasculitis,which is likely to result in acute aortic syndromes.CASE SUMMARY A 44-year-old man with a history of acute Stanford type A aortic dissection status post-reconstructive surgery five years ago.The contrast-enhanced computed tomography of the chest at that time had also revealed an intralobar pulmonary sequestration in the left lower lung region,and the angiography also presented perivascular changes with mild mural thickening and wall enhancement,which indicated mild vasculitis.The intralobar pulmonary sequestration in the left lower lung region was long-term unprocessed,which was probably associated with his intermittent chest tightness since no specific medical findings were detected but only positive sputum culture with mycobacterium avium-intracellular complex and Aspergillus.We performed uniportal video-assisted thoracoscopic surgery with wedge resection of the left lower lung.Hypervascularity over the parietal pleura,engorgement of the bronchus due to a moderate amount of mucus,and firm adhesion of the lesion to the thoracic aorta were histopathologically noticed.CONCLUSION We hypothesized that a long-term pulmonary sequestration-related bacterial or fungal infection can result in focal infectious aortitis gradually,which may threateningly aggravate the formation of aortic dissection.展开更多
Purposes: Intralobar pulmonary sequestration is a rare congenital anomaly that causes nonspecific respiratory symptoms. This report presented our surgical experience for pediatric cases of intralobar pulmonary sequest...Purposes: Intralobar pulmonary sequestration is a rare congenital anomaly that causes nonspecific respiratory symptoms. This report presented our surgical experience for pediatric cases of intralobar pulmonary sequestration in our institute. Methods: Between 2002 and 2014, 30 pediatric patients with intralobar pulmonary sequestration underwent lobectomy. The clinical characteristics of patients were retrospectively analyzed using medical records and imaging data. Results: The median age at operation was 23 months. The sequestered lung was situated in the right lower lung in 15 cases and in the left lower lung in 15 cases. Eight cases were prenatally diagnosed by fetal ultrasound and magnetic resonance imaging. One aberrant artery was seen in 26 cases and two aberrant arteries in 4 cases. The drainage vein from the sequestered lung was: 1) the pulmonary vein in 27 cases;2) the inferior vena cava in 1 case;and 3) the azygos vein and the pulmonary vein in 2 cases. All patients underwent lower lobectomy of the affected side without postoperative early and long-term complications. Conclusion: Due to the increased rate of prenatal diagnoses, the age at operation has decreased. With respect to safety, it is vital to ascertain the number of aberrant arteries and the venous drainage route before lobectomy.展开更多
目的对肺隔离症的分类、发病率、临床特点、诊断和外科治疗加以探讨。方法回顾性分析23例肺隔离症的临床资料及文献复习。结果自1974年6月至2006年11月间经手术治疗和病理确诊的23例肺隔离症,发病率占同期手术的0.29%,其中叶内型19例(83...目的对肺隔离症的分类、发病率、临床特点、诊断和外科治疗加以探讨。方法回顾性分析23例肺隔离症的临床资料及文献复习。结果自1974年6月至2006年11月间经手术治疗和病理确诊的23例肺隔离症,发病率占同期手术的0.29%,其中叶内型19例(83%),叶外型4例(17%);18例表现为反复肺部感染,症状为发热、咳嗽、咯血,5例无症状。术前确诊或拟诊14例(61%)。结论肺隔离症诊断方法主要为 X 线、胸 CT、MRI 检查,一旦确诊均应手术治疗。展开更多
文摘Arterial supply of an intralobar pulmonary sequestration(IPS) from the coronary circulation is extremely rare. A significant coronary steal does not occur because of dual or triple sources of blood supply to sequestrated lung tissue. We present a 60-year-old woman who presented to us with repeated episodes of monomorphic ventricular tachycardia(VT) in last 3 mo. Radio frequency ablation was ineffective. On evaluation, she had right lower lobe IPS with dual arterial blood supply, i.e., right pulmonary artery and the systemic arterial supply from the right coronary artery(RCA). Stress myocardial perfusion scan revealed significant inducible ischemia in the RCA territory. Coronary angiogram revealed critical stenosis of proximal RCA just after the origin of the systemic artery supplying IPS. The critical stenosis in the RCA was stented. At 12 mo follow-up, she had no further episodes of VT or angina.
文摘BACKGROUND Pulmonary sequestrations often lead to serious complications such as infections,tuberculosis,fatal hemoptysis,cardiovascular problems,and even malignant degeneration,but it is rarely documented with medium and large vessel vasculitis,which is likely to result in acute aortic syndromes.CASE SUMMARY A 44-year-old man with a history of acute Stanford type A aortic dissection status post-reconstructive surgery five years ago.The contrast-enhanced computed tomography of the chest at that time had also revealed an intralobar pulmonary sequestration in the left lower lung region,and the angiography also presented perivascular changes with mild mural thickening and wall enhancement,which indicated mild vasculitis.The intralobar pulmonary sequestration in the left lower lung region was long-term unprocessed,which was probably associated with his intermittent chest tightness since no specific medical findings were detected but only positive sputum culture with mycobacterium avium-intracellular complex and Aspergillus.We performed uniportal video-assisted thoracoscopic surgery with wedge resection of the left lower lung.Hypervascularity over the parietal pleura,engorgement of the bronchus due to a moderate amount of mucus,and firm adhesion of the lesion to the thoracic aorta were histopathologically noticed.CONCLUSION We hypothesized that a long-term pulmonary sequestration-related bacterial or fungal infection can result in focal infectious aortitis gradually,which may threateningly aggravate the formation of aortic dissection.
文摘Purposes: Intralobar pulmonary sequestration is a rare congenital anomaly that causes nonspecific respiratory symptoms. This report presented our surgical experience for pediatric cases of intralobar pulmonary sequestration in our institute. Methods: Between 2002 and 2014, 30 pediatric patients with intralobar pulmonary sequestration underwent lobectomy. The clinical characteristics of patients were retrospectively analyzed using medical records and imaging data. Results: The median age at operation was 23 months. The sequestered lung was situated in the right lower lung in 15 cases and in the left lower lung in 15 cases. Eight cases were prenatally diagnosed by fetal ultrasound and magnetic resonance imaging. One aberrant artery was seen in 26 cases and two aberrant arteries in 4 cases. The drainage vein from the sequestered lung was: 1) the pulmonary vein in 27 cases;2) the inferior vena cava in 1 case;and 3) the azygos vein and the pulmonary vein in 2 cases. All patients underwent lower lobectomy of the affected side without postoperative early and long-term complications. Conclusion: Due to the increased rate of prenatal diagnoses, the age at operation has decreased. With respect to safety, it is vital to ascertain the number of aberrant arteries and the venous drainage route before lobectomy.
文摘目的对肺隔离症的分类、发病率、临床特点、诊断和外科治疗加以探讨。方法回顾性分析23例肺隔离症的临床资料及文献复习。结果自1974年6月至2006年11月间经手术治疗和病理确诊的23例肺隔离症,发病率占同期手术的0.29%,其中叶内型19例(83%),叶外型4例(17%);18例表现为反复肺部感染,症状为发热、咳嗽、咯血,5例无症状。术前确诊或拟诊14例(61%)。结论肺隔离症诊断方法主要为 X 线、胸 CT、MRI 检查,一旦确诊均应手术治疗。
