Anomalous Systemic Artery to the Left Lower Lobe: Literature Review and a New Surgical Technique

2018 ◽  
Vol 9 (3) ◽  
pp. 326-332
Author(s):  
Jacob R. Miller ◽  
Timothy S. Lancaster ◽  
Aaron M. Abarbanell ◽  
Peter B. Manning ◽  
Pirooz Eghtesady

Anomalous systemic arterial supply to the basal segments of the left lower lobe without coexisting pulmonary artery connection is a rare anomaly. Most feel treatment is necessary; however, the ideal strategy is unclear. Treatments described include embolization, pulmonary resection, or anastomosis to the native pulmonary artery. We recently encountered an infant with this anomaly and present a literature review summarizing all recent reports. Additionally, we describe a novel surgical technique to create a tension-free anastomosis utilizing segmental aortic translocation that we employed in our patient due to a large distance between the anomalous vessel and native left pulmonary artery.

1989 ◽  
Vol 67 (2) ◽  
pp. 528-533 ◽  
Author(s):  
P. T. Overand ◽  
M. J. Bishop ◽  
B. L. Eisenstein ◽  
E. Y. Chi ◽  
M. Su ◽  
...  

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.


2014 ◽  
Vol 25 (5) ◽  
pp. 1012-1014 ◽  
Author(s):  
Supratim Sen ◽  
David S. Winlaw ◽  
Gary F. Sholler

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.


2019 ◽  
Vol 30 (1) ◽  
pp. 154-155
Author(s):  
Ambria S Moten ◽  
Abbas E Abbas

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.


2015 ◽  
Vol 56 (9) ◽  
pp. 1100-1104 ◽  
Author(s):  
Jie Qin ◽  
Xiao-li Wang ◽  
Ming-jun Bai ◽  
Shao-hong Huang ◽  
Xiu-zhen Chen ◽  
...  

2007 ◽  
Vol 133 (5) ◽  
pp. 1384-1385 ◽  
Author(s):  
Rogier Jaspers ◽  
Wout Barendregt ◽  
Gijs Limonard ◽  
Frank Visser

2003 ◽  
Vol 18 (2) ◽  
pp. 79-84 ◽  
Author(s):  
Edvin Prifti ◽  
Massimo Bonacchi ◽  
Bruno Murzi ◽  
Adrian Crucean ◽  
Massimo Bernabei ◽  
...  

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