scholarly journals Pneumonectomy is necessary following delayed detection of pulmonary artery compromise

2019 ◽  
Vol 30 (1) ◽  
pp. 154-155
Author(s):  
Ambria S Moten ◽  
Abbas E Abbas
Keyword(s):  
Pulmonary Artery ◽  
Blood Supply ◽  
Lung Tissue ◽  
Collateral Circulation ◽  
Lower Lobe ◽  
Left Lower Lobe ◽  
Completion Pneumonectomy

Abstract It has been previously suggested that lung tissue remains viable without blood supply from the pulmonary artery (PA). However, our experience demonstrates otherwise. We present 2 cases of accidental left lower lobe PA occlusion during upper lobectomy causing ischaemic changes to the remaining lung tissue. Both patients became septic secondary to necrosis of infarcted lung and required completion pneumonectomy. Development of collateral circulation to bypass the occluded PA may occur but is often insufficient to support the affected lung tissue. Unless the patient is medically unfit, resection of the ischaemic lung should be undertaken.

Lack of alveolar O2 during lung reperfusion does not decrease edema formation

1989 ◽  
Vol 67 (2) ◽  
pp. 528-533 ◽  
Author(s):  
P. T. Overand ◽  
M. J. Bishop ◽  
B. L. Eisenstein ◽  
E. Y. Chi ◽  
M. Su ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Left Lung ◽  
Lower Lobe ◽  
Arterial Occlusion ◽  
Dry Weight ◽  
Left Pulmonary Artery ◽  
Left Lower Lobe ◽  
Edema Formation ◽  
Alveolar Hypoxia ◽  
The Right

We previously reported that pulmonary arterial occlusion for 48 h followed by 4 h of reperfusion in awake dogs results in marked edema and inflammatory infiltrates in both reperfused and contralateral lungs (Am. Rev. Respir. Dis. 134: 752–756, 1986; J. Appl. Physiol. 63: 942–950, 1987). In this experiment we study the effects of alveolar hypoxia on this injury. Anesthetized dogs underwent thoracotomy and occlusion of the left pulmonary artery. Twenty-four hours later the dogs were reanesthetized, and a double-lumen endotracheal tube was placed. The right lung was continuously ventilated with an inspiratory O2 fraction (FIO2) of 0.35. In seven study animals the left lung was ventilated with an FIO2 of 0 for 3 h after the left pulmonary artery occluder was removed. In six control animals the left lung was ventilated with an FIO2 of 0.35 during the same reperfusion period. Postmortem bloodless wet-to-dry weight ratios were 5.87 +/- 0.20 for the left lower lobe and 5.32 +/- 0.12 for the right lower lobe in the dogs with hypoxic ventilation (P less than 0.05 for right vs. left lobes). These values were not significantly different from the control dog lung values of 5.94 +/- 0.22 for the left lower lobe and 5.11 +/- 0.07 for the right lower lobe (P less than 0.05 for right vs. left lobes). All values were significantly higher than our laboratory normal of 4.71 +/- 0.06. We conclude that reperfusion injury is unaffected by alveolar hypoxia during the reperfusion phase.

Partial anomalous left pulmonary artery: report of two cases and review of literature

2014 ◽  
Vol 25 (5) ◽  
pp. 1012-1014 ◽  
Author(s):  
Supratim Sen ◽  
David S. Winlaw ◽  
Gary F. Sholler
Keyword(s):  
Pulmonary Artery ◽  
Lower Lobe ◽  
Left Pulmonary Artery ◽  
Primary Diagnosis ◽  
Left Lower Lobe ◽  
Lobe Bronchus ◽  
First Child ◽  
Right Pulmonary Artery ◽  
The Right ◽  
Aortic Arch Hypoplasia

AbstractWe describe two cases of anomalous origin of the left lower-lobe pulmonary artery from the right pulmonary artery. The primary diagnosis was mitral atresia, hypoplastic left ventricle, aortic arch hypoplasia in the first child, and tetralogy of Fallot in the second. In both cases, the pulmonary trunk gave rise to a left pulmonary artery in the normal position. In addition, a second branch of the left pulmonary artery arose from the right pulmonary artery, and passed posterior and inferior to the left main or upper-lobe bronchus to supply the left lower lobe. In this review, we compare our findings with previously reported examples of this extremely rare cardiac malformation, and discuss possible embryological explanations for the lesion.

Pulmonary Hyaline Membranes and Vascular Anomalies of the Lung

PEDIATRICS ◽  
1963 ◽  
Vol 32 (6) ◽  
pp. 1094-1097
Author(s):  
C. BOZIC
Keyword(s):  
Pulmonary Artery ◽  
Lower Lobe ◽  
Hyaline Membrane Disease ◽  
Left Lower Lobe ◽  
Vascular Anomalies ◽  
The Third ◽  
Hyaline Membranes ◽  
Hyaline Membrane ◽  
Inferior Portion ◽  
Aberrant Vessels

We have described an infant who died on the third day of life with typical hyaline membrane disease in all portions of the lung perfused by the pulmonary artery. The inferior portion of the left lower lobe, which was separately perfused by three aberrant vessels from the aorta, was emphysematous and had no hyaline membranes. It seems likely that the inequalities in oxygenation of the lung played a role in the localization of the disease.

scholarly journals Rare Presentation of Left Lower Lobe Pulmonary Artery Dissection

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
René Hako ◽  
Ján Fedačko ◽  
Štefan Tóth ◽  
Radoslav Morochovič ◽  
Pavol Kristian ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Arterial Hypertension ◽  
Pulmonary Artery ◽  
Arterial Hypertension ◽  
Lower Lobe ◽  
Pulmonary Angiography ◽  
Left Lower Lobe ◽  
Artery Dissection ◽  
Chronic Pulmonary Hypertension ◽  
Pulmonary Arterial

Background. Pulmonary arterial dissection with chronic pulmonary arterial hypertension as its major cause is a very rare but life-threatening condition. In most cases the main pulmonary trunk is the affected site usually without involvement of its branches. Segmental or lobar pulmonary artery dissection is extremely rare. Case Presentation. We report a unique case of left lower lobe pulmonary artery dissection in a 70-year-old male, with confirmed chronic pulmonary hypertension. To confirm dissection MDCT pulmonary angiography was used. Multiplanar reformation (MPR) images in sagittal, coronal, oblique sagittal, and curved projections were generated. This case report presents morphologic CT features of rare chronic left lobar pulmonary artery dissection associated with chronic pulmonary hypertension at a place of localised pulmonary artery calcification. CT pulmonary angiography excluded signs of thromboembolism and potential motion or flow artefacts. Conclusion. To the best of our knowledge, no case of lower lobe pulmonary artery dissection with flap calcification has been reported yet. CT imaging of the chest is a key diagnostic tool that is able to detect an intimal flap and a false lumen within the pulmonary arterial tree and is preferred in differential diagnosis of rare complications of sustained pulmonary arterial hypertension.

Case 13.1

2014 ◽  
pp. 615-616
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Embolus ◽  
Main Pulmonary Artery ◽  
Lower Lobe ◽  
Left Lower Lobe ◽  
Shortness Of Breath ◽  
Left Main ◽  
Contrast Enhanced ◽  
Oblique Images

80-year-old man with a left lower lobe adenocarcinoma, for which he is receiving radiotherapy, presents with cough and shortness of breath; MRI was requested to evaluate for pulmonary embolus Coronal oblique images from 3D contrast-enhanced pulmonary MRA (Figure 13.1.1) reveal filling defects in the left main pulmonary artery and both lobar arteries....

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