Anomalous systemic arterial supply to the normal
|
|
- Stanley Albert Osborne
- 6 years ago
- Views:
Transcription
1 Anomalous Systemic Arterial Supply to Normal Basal Segments of the Left Lower Lobe Akira Yamanaka, D, Takashi Hirai, D, Toshio ujimoto, D, itsuo Hase, D, asato Noguchi, D, and umio Konishi, D Departments of Chest Surgery, Respiratory Diseases, Radiology, and Pathology, ukui Red Cross Hospital, ukui, Japan Background. Anomalous arterial supply to the normal basal segments of the lower lobe without sequestration is a rare congenital abnormality, and whether it belongs to the broad spectrum of sequestration disorders remains controversial. ethods. The cases of all 4 patients who were treated surgically by us were reviewed together with 8 previously reported cases. Results. The anomalous artery originated from the descending thoracic aorta, distributed to the basal segments of the left lower lobe, and drained to a normal inferior pulmonary vein in each case. The anomalous artery was thick and elastic walled. rom the review of all 12 cases, male gender, left side, descending thoracic aorta as the aberrant arterial origin, absence of pulmonary blood flow to the basal segments, and normal pulmonary venous drainage were predominant. Despite some differences, the findings seemed closely related to intralobar sequestration. Surgical treatments were lung resection, anastomosis, and ligation of the anomalous artery. Conclusions. This anomaly is probably one type of sequestration complex. Both aortic and pulmonary arterial angiographic studies are needed to plan the definitive surgical procedure. (Ann Thorac Surg 1999;68:332 8) 1999 by The Society of Thoracic Surgeons Anomalous systemic arterial supply to the normal basal segments with normal bronchial connection of the lower lobe, which has no normal pulmonary arterial supply without sequestration, is a rare congenital anomaly. It was previously classified as one type of sequestration according to Pryce s terminology, but some synonyms have also been used. Whether the term sequestration is appropriate or not is controversial because of normal bronchial connections. This report describes our experience with various surgical treatments for anomalous arterial supply to the normal basal segments of the left lower lobe and reviews the other cases previously reported to date. Patients and ethods Patient 1 A 29-year-old man was referred to our hospital because of hemoptysis. Chest roentgenogram and computed tomography (CT) showed a retrocardiac nodular shadow. Preoperative bronchoscopy showed normal findings. Transbronchial biopsy could not provide a diagnosis of the lesion. The size of the nodule was unchanged despite the administration of antituberculous agents. Exploratory thoracotomy was performed to rule out lung cancer. A large systemic artery arising from the descending thoracic aorta supplied the basal segments of the lower lobe of the left lung. The pulmonary arteries to the basal Accepted for publication eb 23, Address reprint requests to Dr Yamanaka, Department of Chest Surgery, ukui Red Cross Hospital, Tsukimi, ukui , Japan; akiray@mitene.or.jp. segments were lacking. The aberrant artery was ligated, and left lower lobectomy was performed. A roentgenogram of the resected lower lobe with injection of contrast medium into the aberrant vessel showed the angiogram of the entire basal segment distribution without fistulae or connections with other vessels (ig 1A). Patient 2 A 30-year-old asymptomatic man was referred to our hospital for evaluation of an abnormal shadow on a chest roentgenogram film. Chest roentgenogram and CT revealed a retrocardiac nodular shadow. agnetic resonance imaging (RI) of the chest revealed a partial defect of the descending thoracic aortic wall and the orifice of the abnormal vessel branching. Aortography showed an anomalous artery from the descending thoracic aorta entering the basal segments of the left lower lobe (ig 1B). Pulmonary arteriography showed a complete lack of pulmonary arterial supply to the basal segments. Preoperative bronchoscopy showed normal findings. The anomalous vessel was transected at its origin, and the proximal end was oversewn with 3-0 polypropylene. Behind the bronchus and the superior segment of the lower lobe, end-to-side anastomosis between the anomalous artery and the inferior side of the pulmonary artery was performed with 5-0 polypropylene without resection of the basal segments. A small section of the lung (S8) was removed for histologic examination. Anticoagulation and antiplatelet therapy were continued. After 6 months, although pulmonary angiography showed that the flow into the lower lobe of the left lung had improved, and a lung perfusion scan revealed little 1999 by The Society of Thoracic Surgeons /99/$20.00 Published by Elsevier Science Inc PII S (99)
2 Ann Thorac Surg YAANAKA ET AL 1999;68:332 8 ANOALOUS SUPPLY TO THE LUNG 333 Patient 3 A 46-year-old man was referred to our hospital because of cough and sputum, with a history of hemoptysis. Chest roentgenogram and CT showed a retrocardiac shadow in the left lower lung field. Chest RI revealed an abnormal vessel from the descending thoracic aorta. Pulmonary arteriograms and aortograms revealed a normal pulmonary arterial supply to the superior segment of the left lower lobe and a large artery arising from the descending thoracic aorta supplying the basal segments of the left lower lobe. There were no pulmonary arteries to the basal segments. Preoperative bronchoscopy showed normal findings. The aberrant artery was ligated, and left lower lobectomy was performed. Patient 4 A 68-year-old woman was referred to our hospital because of exertional dyspnea with a history of hemoptysis. Chest roentgenogram film showed a retrocardiac shadow, and chest CT was suggestive of an anomalous systemic arterial supply to the left lower lobe. Chest RI revealed a partial defect of the descending aortic wall. The pulmonary arteriograms and the aortograms revealed a normal pulmonary arterial supply to the superior segment of the left lower lobe and a large artery arising from the descending thoracic aorta supplying the basal segments of the left lower lobe. There were no pulmonary arteries to the basal segments. Preoperative bronchoscopy showed normal findings. As the interlobar lobulation was incomplete, and basalectomy of the left lower lobe with ligation of the aberrant artery was performed. Results Case Summaries The clinical features of the 4 patients are summarized in Table 1. ig 1. Angiography of the anomalous arteries: (A) patient 1, (B) patient 2. In patient 1, the anomalous artery in the resected lobe is injected with barium sulfate. In patient 2, preoperative angiogram is demonstrated. Anomalous artery distributes into all basal segments. improvement in that value. ive years after surgery, the patient had no respiratory symptoms. Arterial blood gas analysis revealed no evidence of right-to-left shunt. CLINICAL ANIESTATIONS. Three were adult men and one was an elderly woman. No patient complained of either severe symptoms or history of respiratory infections. Patients 1, 3, and 4 were admitted with clinical symptoms, while patient 2 had no respiratory symptoms. Although the final diagnosis was made during a surgical operation in patient 1, a preoperative diagnosis was achieved in the 3 other patients. Cardiac murmurs or abnormal electrocardiogram (ECG) findings were not detected in any of the patients. In blood studies, no inflammatory findings were demonstrated. Bronchoscopy, which was performed in each patient, showed all major bronchi of the left lung to be in their normal location. ROENTGENOLOGICAL INDINGS AND ANGIOGRAPHY. In the first case, an angiogram of the resected specimen seemed to show the same findings as the other three cases. The contrast medium filled the capillaries without leakage into other vessels (ig 1A). In the other 3 cases, a preoperative angiogram showed that the left basal seg-
3 334 YAANAKA ET AL Ann Thorac Surg ANOALOUS SUPPLY TO THE LUNG 1999;68:332 8 Table 1. Clinical eatures of the Patients Variable Patient 1 Patient 2 Patient 3 Patient 4 Age (y), gender 29, male 30, male 46, male 68, female Symptom hemoptysis asymptomatic cough, sputum dyspnea, hemopytsis Supply descending thoracic aorta Side, location left pulmonary ligament Distribution left basal segments No. of arteries Diameter (origin, maximum, mm) 7, 30 8, 9 15, 20 5, 20 Pulmonary artery no pulmonary arteries to the basal segments branching Drainage normal inferior pulmonary venous drainage into the left atrium Aortic arch normal left aortic arch Intrathoracic anomaly none Surgery lower lobectomy anastomosis a lower lobectomy basalectomy a End-to-side anastomosis between the anomalous artery and the inferior side of the pulmonary artery. ments were supplied by one anomalous artery arising from the descending thoracic aorta without pulmonary blood flow. The anomalous artery was smaller in diameter, running caudally at its origin, tortuous until it ran cranially to the proximal lower lobe like a swan neck-shaped curve, and then it was dilated aneurysmatically running along with a normal pulmonary artery into all the basal segments. There was a normal pulmonary capillary phase, and normal inferior pulmonary venous drainage into the left atrium, thereby excluding a direct fistula between the aberrant systemic artery and the pulmonary veins (ig 1B). Chest CT was performed in each patient. As a general feature, it showed a lobulated or branching nodular shadow with many tangentially cut vessels around it (ig 2). Chest RI was performed in 3 patients, excluding the first, and showed a defect of the aortic wall at the branching orifice of the aberrant artery (ig 3). OPERATIVE INDINGS AND SURGICAL PROCEDURE. The chest was opened by a posterolateral incision. At thoracotomy, intrapleural findings included normal left aortic arch without pleural adhesion, lung hypoplasia, or diaphragmatic hernia. The visceral pleura of the basal segments of the lower lobe was covered with many telangiectases and anthoracoses, and the lower lobe ventilated well with no masses. At its origin, the anomalous artery was smaller in diameter (mean 9 mm in diameter) in the pulmonary ligament, but just beyond this site entering the lobe, it dilated aneurysmatically (mean 20 mm in diameter). The left inferior pulmonary vein was normal in size. There was no degenerate connection between the anomalous artery and pulmonary artery. Left lower lobectomy with ligation of the anomalous artery was performed in patients 1 and 3, left basalectomy with ligation of the anomalous artery in patient 4, and anastomosis between the anomalous artery and pulmonary artery without resection of the basal segments in patient 2. The postoperative course was uneventful and resulted in clinical improvement in each patient. ig 2. Chest CT: patient 2 (top), patient 4 (bottom). In patient 2, the lobulated nodular shadow is demonstrated at the proximal lower lobe. In patient 4, the nodular vascular shadow with tangentially cut vessels around itself is observed.
4 Ann Thorac Surg YAANAKA ET AL 1999;68:332 8 ANOALOUS SUPPLY TO THE LUNG 335 Review of the Literature Previously reported cases in the English literature including the present 4 cases are summarized in Table 2. The cases of systemic artery-pulmonary vein fistula or those with an inflammatory mass in the resected specimen were excluded. Age distribution was from 0 months to 68 years, below 6 years in 6 and over 20 years in 6, with an average age of 21.2 years. ale gender, left side, and descending thoracic aorta as the aberrant arterial origin were predominant. In all cases, the number of anomalous arteries was one. The perfusion area of the anomalous artery was the basal segments of the lower lobe with normal pulmonary venous drainage into the left atrium. In one of the right-sided cases, the aberrant artery arose from the celiac axis. Surgical procedures were lobectomy in 9 cases, basalectomy in 1, and anastomosis between the anomalous artery and pulmonary artery in 2. ig 3. Chest RI: patient 3 (top), patient 4 (bottom). A defect of the aortic wall (arrow) at the branching point of the anomalous artery is observed. HISTOPATHOLOGICAL INDINGS. Resected specimens were obtained from all patients. Histopathological examination showed that the anomalous arteries were tortuous, thick walled, and elastic, and had atherosclerotic change. There was fibrosis, scattered hemosiderin-laden macrophages in the lung parenchyma, and a thrombus in a peripheral artery in each case. In the peripheral area, airway and artery with a thick elastic wall in the bronchoarterial bundle were shown. In the small bundle, the pulmonary artery was narrower or showed obstructive change. There was no evidence of bronchiectasis, chronic infection, sequestration, or dysplastic change. Comment Anomalous systemic arterial supply to normal segments of the lung is a rare congenital anomaly. This disease has been classified as Pryce type I sequestration [1]. Recently, some synonyms: systemic arterial supply to (the basal segments of) the lung, etc. [2 6], systemic origin of the sole artery to the basal segments of the lung [7], or systemic arterialization of lung without sequestration [8, 9], have also been used for this condition. Despite this nomenclature, Sade and associates [10] introduced the concept of a sequestration spectrum for the classification of various complexes of bronchovascular anomalies. The concept that this anomaly is one of the subtypes of this spectrum was reviewed by Thilenius and associates [11]. But whether the term sequestration is appropriate remains controversial. As a similar spectrum concept, Clements and Warner [12] presented pulmonary malinosculation spectrum. Pulmonary sequestration is defined as a mass of abnormal pulmonary tissue that does not communicate with the tracheobronchial tree through a normally located bronchus and that is supplied by an anomalous systemic artery [10]. According to this definition, the anomaly we are reviewing cannot be considered a type of true pulmonary sequestration, because the lesion of bronchopulmonary and parenchymal tissue of this disease is never sequestered. urthermore, if any pulmonary lesion with systemic arterial supply is included in the sequestration, it seems questionable whether the lung is sequestered in the patients with combined supply from the normal pulmonary artery and anomalous systemic artery to normal lung parenchyma [6, 9, 13], as shown in Table 3, or in patients with a systemic arterypulmonary vein fistula. Despite these differences, systemic arterial supply to normal lung is probably closely related to pulmonary sequestration. The location of this disease is the lower lobe, especially in the basal segments, as is true of most cases of pulmonary sequestration. The characteristics of these aberrant arteries, whose origin is in the pulmonary ligament or below the diaphragm and that have histologically an elastic-type (so-called pulmonary type) arterial wall, are the same as in pulmonary sequestration. Several investigators [1, 7, 12, 14] have indicated that the aberrant arteries in this disease as well as in pulmonary sequestration are distinct from bronchial arteries. The venous
5 336 YAANAKA ET AL Ann Thorac Surg ANOALOUS SUPPLY TO THE LUNG 1999;68:332 8 Table 2. Review of the Literature Published in English to Date Including Present Cases of Anomalous Systemic Arterial Supply to the Normal Basal Segments of the Lower Lobe Reference Year Age, Gender Clinical anifestations Side Origin No. of Arteries Arterial Perfusion to Lower Lobe PA Perfusion to Lower Lobe Drainage Surgery 1. Hessel [7] y, 2. Litwin mo, [20] 3. Kirks y, [2] 4. Kirks mo, [2] 5. Ishihara y, [4] 6. Yabek mo, [3] 7. lisak y, [8] 8. Tao [5] y, 9. Present y, 10. Present y, 11. Present y, 12. Present y, heart murmur L DTA 1 basal segments S6 IPV anastomosis heart murmur, R DTA 1 basal segments S6 IPV a lobectomy respiratory distress heart murmur L DTA 1 basal segments S6 IPV lobectomy heart murmur L DTA 1 basal segments S6 IPV lobectomy heart murmur L DTA 1 basal segments S6 IPV a lobectomy heart murmur, L DTA 1 basal segments S6 IPV lobectomy respiratory distress dyspnea, hemoptysis R celiac 1 basal segments a S6 IPV a lobectomy axis dyspnea L DTA 1 basal segments S6 IPV lobectomy hemoptysis L DTA 1 basal segments S6 IPV lobectomy abnormal shadow L DTA 1 basal segments S6 IPV anastomosis cough, sputum L DTA 1 basal segments S6 IPV lobectomy dyspnea, hemoptysis L DTA 1 basal segments S6 IPV basalectomy Limited listing of the cases in which the anomalous artery is the sole arterial supply to the involved segments. a Description is not clear. DTA descending thoracic aorta; IPV inferior pulmonary vein; L left; PA pulmonary artery; R right. drainage is the pulmonary vein, which is consistent with intralobar sequestration rather than extralobar type. In some reported cases of pulmonary sequestration, a normal communication with a normal bronchial tree was evident without inflammatory change [15]. These findings suggest the difficulty in considering this anomaly as a completely independent disease from pulmonary sequestration. rom the standpoint of embryology, bronchial growth is dependent not only on the available celomic space [16], but also on pulmonary arteries, which provide the primary blood supply to developing lung tissue [1], with bronchial blood supply alone insufficient to supply the nutritional needs of the growing fetal lung [16]. As regards lung development, we cannot separate the relations between the bronchial bud and adjacent artery. If we define the term sequestration as a congenital nonfunctioning pulmonary lesion mainly supplied by an anomalous systemic artery, anomalous arte- Table 3. Review of the Literature Published in English to Date of Anomalous Systemic Arterial Supply to Normal Lower Lobe of the Lung Reference Year Age, Gender Clinical anifestations Side Origin No. of Arteries Arterial Perfusion to Lower Lobe PA Perfusion to Lower Lobe Drainage Surgery 1. Campbell [6] y, 2. Campbell mo, [6] 3. Painter [9] y, 4. Ernst [13] y, abnormal shadow R Abd A 2 basal segments N SPV lobectomy heart murmur L DTA 1 basal segments a N IPV ligation hemoptysis R celiac 1 basal segments a N IPV segmentectomy axis heart murmur R Abd A 1 basal segments N IPV a ligation Limited listing of the cases in which the normal pulmonary artery is also the arterial supply to the involved segments. a Description is not clear. Abd A abdominal aorta; DTA descending thoracic aorta; IPV inferior pulmonary vein; L left; N normal; PA pulmonary artery; R right; SPV superior pulmonary vein.
6 Ann Thorac Surg YAANAKA ET AL 1999;68:332 8 ANOALOUS SUPPLY TO THE LUNG 337 rial supply to normal lung may be included in the wide spectrum of pulmonary sequestration. It would be named arterial sequestration, whereas classical pulmonary sequestration would be named broncho-arterial sequestration, as Thilenius and associates [11] previously suggested. The embryology of the lung and its relationship to this anomaly have been summarized by several authors. At about 28 days of embryonic life (main bronchi appear, when the embryo is 4.6 mm long) [17, 18], the lung bud is supplied by systemic capillaries, the splanchnic plexus [8, 10] or primitive bronchial arteries [8, 17], which have numerous connections with the primitive dorsal aorta [8, 10, 12, 17] in the neck near the celiac axis [17]. At the 5th week (lobar bronchi appearance, 8.5 mm) [17, 18], from the caudally directed ventral sprouts of the sixth aortic arch, plexiform vessels (pulmonary arteries) appear and grow toward the lung bud [16, 17]. The ventral and dorsal sixth branch is connected and forms the sixth arch. At the 6th week (segmental bronchi appearance) [17], the splanchnic supply normally regresses once the pulmonary arterial system becomes established [8, 12, 17]. Pulmonary oligemia [8] or other events are factors with either persistence or reestablishment of pulmonarysplanchnic collaterals. The most likely theory is that if the early branches arising from the aorta persist, this causes one type of anomalous systemic supply to the lung [2, 7, 16, 17]. The case with combined supply from the pulmonary artery and systemic artery to normal lung parenchyma might also support this theory. As far as definitive bronchial arteries are concerned, they develop between the 9th and 12th week and communicate with the capillary bed in the airway walls [16, 17]. In all our cases, the anomalous systemic artery arose from the descending thoracic aorta and supplied solely the left normal basal segments with normal pulmonary venous drainage into the left atrium without associated normal pulmonary arterial supply to the involved segments. Although the majority of the reported cases exhibit almost the same pattern as our cases [2 5, 7], other cases in which the anomalous artery supplies the right lower lobe or arises from the celiac axis also exist. As shown in Table 3, some reported cases had a normal pulmonary arterial supply in addition to anomalous systemic arterial supply to the involved segments [6, 9, 13]. Of these 4 cases, the anomalous systemic artery arose from the descending thoracic aorta in 1 [6], and from the abdominal aorta (or the celiac axis) in 3 [6, 9, 13]. They should also be included in the wide spectrum of pulmonary sequestration as an incomplete type of anomalous systemic arterial supply to normal lung. As a general trend, anomalous artery arising from the descending thoracic aorta supplied the left lower lobe, while the one arising from the abdominal aorta (or the celiac axis) supplied the right lower lobe with normal pulmonary arterial branches as well. As regards the morphological findings, the anomalous artery was smaller in diameter at its origin in the pulmonary ligament, but dilated just beyond this site entering the lobe, especially in the left-sided cases. It was also observed that the surface of the affected segments was covered with many telangiectases. Although most of the patients are asymptomatic, the main clinical symptoms of this disease are hemoptysis [8, 9] and exertional dyspnea [3, 5, 8]. Asymptomatic patients were referred because of abnormal shadow or cardiac murmur. Physical examination revealed heart murmurs over the precordium and the lower posterior thorax in children [4], but not in the older patients. Heart murmurs were continuous murmurs simulating a patent ductus arteriosus [2, 3, 7] or systolic murmurs [2, 4]. Occasionally, the shunt, when sufficiently large, produced leftsided cardiac overload and congestive heart failure [3]. In pediatric patients, ECG was used to show left ventricular hypertrophy. The diagnosis should be suspected in the presence of a continuous murmur or unilateral increase in pulmonary blood flow in pediatric patients. In older patients, roentgenological findings are more important than physical examinations. CT is useful for the diagnosis and showed a retrocardiac nodular (vascular) shadow connected to the descending aorta branching into the basal segments of the relatively normal lower lobe [5, 19]. CT was performed in all our 4 cases. Although our first patient was misdiagnosed, a preoperative diagnosis was achieved by CT in the other 3 patients. It shows a retrocardiac nodular shadow that lobulates and runs circumferentially, and demonstrates a nearly normal bronchial tree and normal pulmonary parenchyma without mass or cystic change. Bronchoscopy confirms the normal major bronchial branchings. Provided this anomaly is kept in mind, the diagnosis is not difficult. The usefulness of RI has also been described in a few reports. In our experience, RI, which was performed in 3 patients, was also useful for showing the abnormal vessel branching from the descending thoracic aorta or a partial defect of the descending aortic wall at the abnormal vessel branching point. Needless to say, angiography is the most useful method to establish the exact diagnosis. To accurately delineate the vascular anatomy and to plan definitive surgical therapy, both aortic and pulmonary arterial angiographic studies are needed. Before deciding the operative procedure, it is necessary to know whether normal pulmonary arteries branch to the involved lung, or whether the aberrant artery provides the blood flow to the entire involved lung with capillary phase, or demonstrates direct drainage of the blood flow into the pulmonary vein. Surgery is indicated for all patients with this anomaly because it is associated with potential risks, such as hemopytsis due to pulmonary hypertension and heart failure due to left-to-left shunt [3]. In most reported cases of this disease, lobectomy was performed. Other operative procedures include segmentectomy, anastomosis between the anomalous artery and pulmonary artery, or ligation of the anomalous artery. In our 4th case, who was probably the oldest patient reported in the literature, basalectomy was performed because of the incompleteness of interlobar lobulation. Hessel and associates [7] first reported successful anastomosis in a 5-year-old boy,
7 338 YAANAKA ET AL Ann Thorac Surg ANOALOUS SUPPLY TO THE LUNG 1999;68:332 8 and described pulmonary artery angiography, which revealed normal flow with no evidence of right-to-left shunt into the lower lobe of the left lung after surgery. This surgical method might be feasible for a pediatric patient in whom the involved segments of pulmonary parenchyma are normal and the anomalous vessel functions physiologically as a pulmonary artery. In our 2nd patient, as he had no airway symptoms, the anastomosis was performed as we previously reported [19]. Although dyspnea on effort improved due to disappearance of the left-to-left shunt, a lung perfusion scan revealed little improvement postoperatively. In such an adult patient, this procedure would likely be inefficacious in preserving the normal lung circulation because of already established atherosclerotic change and obstruction with thrombus of the anomalous artery. The last procedure, ligation of the anomalous arteries only, can be indicated for patients whose lung tissue has normal pulmonary artery branches [6, 13] in addition to those with systemic artery-pulmonary vein fistula. References 1. Pryce D. Lower accessory pulmonary artery with intralobar sequestration of lung: a report of seven cases. J Pathol 1946;58: Kirks DR, Kane PE, ree EA, Taybi H. Systemic arterial supply to normal basilar segments of the left lower lobe. Am J Radiol 1976;126: Yabek S, Burstein J, Berman W Jr, Dillon T. Aberrant systemic arterial supply to the left lung with congestive heart failure. Chest 1981;80: Ishihara Y, ukuda R, Awaya Y, et al. Anomalous systemic arterial supply to the basal segments of the lung presenting with a murmur. Eur J Pediatr 1979;131: Tao CW, Chen CH, Yuen KH, Huang H, Li WY, Perng RP. Anomalous systemic arterial supply to normal basilar segments of the lower lobe of the left lung. Chest 1992;102: Campbell DC Jr, urney JA, Dominy DE. Systemic arterial blood supply to a normal lung. J Am ed Assoc 1962;182: Hessel EA II, Boyden EA, Stamm SJ, Sauvage LR. High systemic origin of the sole artery to the basal segments of the left lung: findings, surgical treatment, and embryologic interpretation. Surgery 1970;67: lisak E, Chandrasekar AJ, arsan RE, Ali. Systemic arterialization of lung without sequestration. Am J Radiol 1982;138: Painter RL, Billig D, Epstein I. Anomalous systemic arterialization of the lung without sequestration. N Engl J ed 1968;279: Sade R, Clouse, Ellis H Jr. The spectrum of pulmonary sequestration. Ann Thorac Surg 1974;18: Thilenius OG, Ruschhaupt DG, Replogle RL, Bharati S, Herman T, Arcilla RA. Spectrum of pulmonary sequestration: association with anomalous pulmonary venous drainage in infants. Ped Cardiol 1983;4: Clements BS, Warner JO. Pulmonary sequestration and related congenital bronchopulmonary-vascular malformations: nomenclature and classification based on anatomical and embryological considerations. Thorax 1987;42: Ernst SPG, Bruschke AVG. An aberrant systemic artery to the right lung with normal pulmonary tissue. Chest 1971;60: Savic B, Birtel J, Tholen W, unke HD, Knoche R. Lung sequestration: report of seven cases and review of 540 published cases. Thorax 1979;34: Takahashi, Ohno, ihara K, atsuura K, Sumiyoshi A. Intralobar pulmonary sequestration. Radiology 1975;114: Hasleton PS. Embryology and development of the lung. In: Hasleton PS, ed. Spencer s pathology of the lung. 5th ed. New York: cgraw-hill, 1996: Deello D, Reid L. Arteries and veins. In: Crystal RG, West JB, Barnes PJ, Cherniack NS, Weibel ER, eds. The lung: scientific foundations. New York: Raven Press, 1991: raser RG, Paré JAP, Paré PD, raser RS, Genereux GP. The normal chest: Development and growth of the lung. In: raser RG, Paré JAP, Paré PD, raser RS, Genereux GP, eds. Diagnosis of diseases of the chest. 3rd ed. Philadelphia: WB Saunders, 1988: Hirai T, Ohtake Y, utoh S, Noguchi, Yamanaka A. Anomalous systemic arterial supply to normal basal segments of the left lower lobe. Chest 1996;109: Litwin SB, Plauth WH Jr, Nadas AS. Anomalous systemic arterial supply to the lung causing pulmonary-artery hypertension. N Engl J ed 1970;283:
Lung sequestration and Scimitar syndrome
Lung sequestration and Scimitar syndrome Imaging approaches M. Mearadji International Foundation for Pediatric Imaging Aid Rotterdam, The Netherlands Pulmonary sequestration Pulmonary sequestration (PS)
More informationPULMONARY VENOLOBAR SYNDROME. Dr.C.Anandhi DNB Resident, Southern Railway Headquarters Hospital.
PULMONARY VENOLOBAR SYNDROME Dr.C.Anandhi DNB Resident, Southern Railway Headquarters Hospital. Presenting complaint: 10 yrs old girl with recurrent episodes of lower respiratory tract infection from infancy.
More informationSpectrum of Pulmonary Sequestration M. Wayne Flye, M.D., Martin Conley, M.D., and Donald Silver, M.D.
Spectrum of Pulmonary Sequestration M. Wayne Flye, M.D., Martin Conley, M.D., and Donald Silver, M.D. ABSTRACT Bronchopulmonary sequestration was diagnosed in 17 patients ranging in age from newborn to
More informationPRESENCE OF LOWER ACCESSORY LOBES IN THE LUNGS
Int. J. Pharm. Med. & Bio. Sc. 2013 Hemanth Kommuru et al., 2013 Research Paper ISSN 2278 5221 www.ijpmbs.com Vol. 2, No. 3, July 2013 2013 IJPMBS. All Rights Reserved PRESENCE OF LOWER ACCESSORY LOBES
More informationCase Report Coexistent Congenital Diaphragmatic Hernia with Extrapulmonary Sequestration
Canadian Respiratory Journal Volume 2016, Article ID 1460480, 4 pages http://dx.doi.org/10.1155/2016/1460480 Case Report Coexistent Congenital Diaphragmatic Hernia with Extrapulmonary Sequestration Nao
More informationPulmonary vascular anatomy & anatomical variants
Review Article Pulmonary vascular anatomy & anatomical variants Asha Kandathil, Murthy Chamarthy Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA Contributions:
More informationVideo-assisted thoracic surgery for pulmonary sequestration: a safe alternative procedure
Original Article Video-assisted thoracic surgery for pulmonary sequestration: a safe alternative procedure Lu-Ming Wang, Jin-Lin Cao, Jian Hu Department of Thoracic Surgery, The First Affiliated Hospital,
More informationCongenital Lung Malformations: Radiologic-Pathologic Correlation
Acta Radiológica Portuguesa, Vol.XVIII, nº 70, pág. 51-60, Abr.-Jun., 2006 Congenital Lung Malformations: Radiologic-Pathologic Correlation Marilyn J. Siegel Mallinckrodt Institute of Radiology, Washington
More information24. An infant with recurrent pneumonia underwent a frontal chest radiograph (Fig 24-A) followed by
24. An infant with recurrent pneumonia underwent a frontal chest radiograph (Fig 24-A) followed by diagnosis? ndings, what is the most likely A. Pulmonary sequestration B. Congenital pulmonary airway malformation
More informationChest and cardiovascular
Module 1 Chest and cardiovascular A. Doss and M. J. Bull 1. Regarding the imaging modalities of the chest: High resolution computed tomography (HRCT) uses a slice thickness of 4 6 mm to identify mass lesions
More informationPulmonary Sequestration
July 26, 2004 Pulmonary Sequestration Jonathan Shaw, Harvard Medical School Year IV What do these two patients have in common? Patient 1: 50 y.o. non-smoking female with several months cough and hemoptysis;
More informationORIGINAL ARTICLE. Complete video-assisted thoracoscopic surgery for pulmonary sequestration
ORIGINAL ARTICLE Complete video-assisted thoracoscopic surgery for pulmonary sequestration Jian-Fei Shen, Xiao-Xue Zhang, Shu-Ben Li, Zhi-Hua Guo, Zhi-Qiang Xu, Xiao-Sun Shi, Jian-Xing He Department of
More informationTwo Cases Report of Scimitar Syndrome: The Classical one with Subaortic Membrane and the Scimitar Variant
Bahrain Medical Bulletin, Vol.22, No.1, March 2000 Two Cases Report of Scimitar Syndrome: The Classical one with Subaortic Membrane and the Scimitar Variant F Hakim, MD* A Madani, MD* A Abu Haweleh, MD,MRCP*
More informationIndividual Pulmonary Vein Atresia in Adults: Report of Two Cases
Case Report DOI: 10.3348/kjr.2011.12.3.395 pissn 1229-6929 eissn 2005-8330 Korean J Radiol 2011;12(3):395-399 Individual Pulmonary Vein Atresia in Adults: Report of Two Cases Hyoung Nam Lee, MD, Young
More informationin PAEDIATRIC CARDIOLOGY
IMAGES in PAEDIATRIC CARDIOLOGY Morrison ML, 1 Sands AJ, 1 Paterson A. 2 Primitive hepatic venous plexus in a child with scimitar syndrome and pulmonary 1 Department of Paediatric Cardiology, Royal Belfast
More informationImaging of the Lung in Children
Imaging of the Lung in Children Imaging methods X-Ray of the Lung (Anteroposterior, ) CT, HRCT MRI USG Congenital developmental defects of the lungs Agenesis, aplasia, hypoplasia Tension pulmonary anomalies
More informationMolla Teshome MD, Habtamu Belete MD Aurora Health Care Internal Medicine Residency Program
Molla Teshome MD, Habtamu Belete MD Aurora Health Care Internal Medicine Residency Program History 32 year-old male who presented with a 4 days history of: Productive cough Right sided pleuritic chest
More informationSurgical indications: Non-malignant pulmonary diseases. Punnarerk Thongcharoen
Surgical indications: Non-malignant pulmonary diseases Punnarerk Thongcharoen Non-malignant Malignant as a pathological term: Cancer Non-malignant = not cancer Malignant as an adjective: Disposed to cause
More informationCase Report Pulmonary Sequestration with Renal Aplasia and Elevated SUV Level in PET/CT
Case Reports in Pulmonology Volume 2012, Article ID 276012, 4 pages doi:10.1155/2012/276012 Case Report Pulmonary Sequestration with Renal Aplasia and Elevated SUV Level in PET/CT Serdar Şen, 1 Nilgün
More informationDR Turner, JA Vincent, and ML Epstein. Isolated right pulmonary artery discontinuity. Images Paediatr Cardiol Jul-Sep; 2(3):
IMAGES in PAEDIATRIC CARDIOLOGY Images PMCID: PMC3232486 Isolated right pulmonary artery discontinuity DR Turner, MD, * JA Vincent, ** and ML Epstein *** * Senior Fellow, Division of Cardiology, Children's
More informationCase Based Fetal Lung Masses
Case Based Fetal Lung Masses Advances in Fetal and Neonatal Imaging Course Orlando, Florida, January 28, 2017 Leann E. Linam, MD Associate Professor Radiology University of Arkansas for Medical Sciences/
More informationStenosis of Pulmonary Veins
Stenosis of Pulmonary Veins Report of a Patient Corrected Surgically Yasunaru Kawashima, M.D., Takeshi Ueda, M.D., Yasuaki Naito, M.D, Eiji Morikawa, M.D., and Hisao Manabe, M.D. ABSTRACT A 15-year-old
More informationHeart and Lungs. LUNG Coronal section demonstrates relationship of pulmonary parenchyma to heart and chest wall.
Heart and Lungs Normal Sonographic Anatomy THORAX Axial and coronal sections demonstrate integrity of thorax, fetal breathing movements, and overall size and shape. LUNG Coronal section demonstrates relationship
More informationCONGENITAL HEART DISEASE (CHD)
CONGENITAL HEART DISEASE (CHD) DEFINITION It is the result of a structural or functional abnormality of the cardiovascular system at birth GENERAL FEATURES OF CHD Structural defects due to specific disturbance
More information9/8/2009 < 1 1,2 3,4 5,6 7,8 9,10 11,12 13,14 15,16 17,18 > 18. Tetralogy of Fallot. Complex Congenital Heart Disease.
Current Indications for Pediatric CTA S Bruce Greenberg Professor of Radiology Arkansas Children s Hospital University of Arkansas for Medical Sciences greenbergsbruce@uams.edu 45 40 35 30 25 20 15 10
More informationIsolated major aortopulmonary collateral as the sole pulmonary blood supply to an entire lung segment
Washington University School of Medicine Digital Commons@Becker Open Access Publications 2017 Isolated major aortopulmonary collateral as the sole pulmonary blood supply to an entire lung segment Hannah
More informationTwo Cases of Incidentally Picked Up Adult Unilateral Pulmonary Artery Atresia with Variable Imaging Features
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 16, Issue 12 Ver. III (Dec. 2017), PP 45-49 www.iosrjournals.org Two Cases of Incidentally Picked Up
More informationThoracoscopic treatment of congenital malformation of the lung
Jemis, 1 2013 Thoracoscopic treatment of congenital malformation of the lung Preliminary experience with preoperative 3D virtual rendering F. Destro M. Maffi T. Gargano G. Ruggeri L. Soler M. Lima Table
More informationDebate in Management of native COA; Balloon Versus Surgery
Debate in Management of native COA; Balloon Versus Surgery Dr. Amira Esmat, El Tantawy, MD Professor of Pediatrics Consultant Pediatric Cardiac Interventionist Faculty of Medicine Cairo University 23/2/2017
More informationEarly View Article: Online published version of an accepted article before publication in the final form.
Early View Article: Online published version of an accepted article before publication in the final form. Journal Name: Edorium Journal of Anatomy and Embryology Type of Article: Case Report Title: Pulmonary
More informationCase report Esophageal lung: a rare case of communicating bronchopulmonary foregut malformation
Case report Esophageal lung: a rare case of communicating bronchopulmonary foregut malformation 1 Dr.Varsha Rathi, 2 Dr. Saurabh Deshpande*, 3 Dr.Almas Nazim, 4 Dr.Shilpa Domkundwar 1 Professor, Department
More informationChest X-ray Interpretation
Chest X-ray Interpretation Introduction Routinely obtained Pulmonary specialist consultation Inherent physical exam limitations Chest x-ray limitations Physical exam and chest x-ray provide compliment
More informationParenchyma-sparing lung resections are a potential therapeutic
Lung Segmentectomy for Patients with Peripheral T1 Lesions Bryan A. Whitson, MD, Rafael S. Andrade, MD, and Michael A. Maddaus, MD Parenchyma-sparing lung resections are a potential therapeutic option
More informationCase 47 Clinical Presentation
93 Case 47 C Clinical Presentation 45-year-old man presents with chest pain and new onset of a murmur. Echocardiography shows severe aortic insufficiency. 94 RadCases Cardiac Imaging Imaging Findings C
More informationDevendra V. Kulkarni, Rahul G. Hegde, Ankit Balani, and Anagha R. Joshi. 2. Case Report. 1. Introduction
Case Reports in Radiology, Article ID 614647, 4 pages http://dx.doi.org/10.1155/2014/614647 Case Report A Rare Case of Pulmonary Atresia with Ventricular Septal Defect with a Right Sided Aortic Arch and
More informationå CASE REPORT å Pulmonary Intralobar Sequestration Accompanied by Aneurysm of an Anomalous Arterial Supply
å CASE REPORT å Pulmonary Intralobar Sequestration Accompanied by Aneurysm of an Anomalous Arterial Supply Akio Koyama, Katsuhisa Sasou, Haruhisa Nakao, Asamitsu Hirano, Hitoshi Hachiya, Masao Iwasaki,
More informationCoronary Artery Anomalies from Birth to Adulthood; the Role of CT Coronary Angiography in Sudden Cardiac Death Screening
Coronary Artery Anomalies from Birth to Adulthood; the Role of CT Coronary Angiography in Sudden Cardiac Death Screening E O Dwyer 1, C O Brien 1, B Loo 1, A Snow Hogan 1, O Buckley1 2, B 1. Department
More informationDr. Weyrich G07: Superior and Posterior Mediastina. Reading: 1. Gray s Anatomy for Students, chapter 3
Dr. Weyrich G07: Superior and Posterior Mediastina Reading: 1. Gray s Anatomy for Students, chapter 3 Objectives: 1. Subdivisions of mediastinum 2. Structures in Superior mediastinum 3. Structures in Posterior
More informationThe sinus venosus represent the venous end of the heart It receives 3 veins: 1- Common cardinal vein body wall 2- Umbilical vein from placenta 3-
1 2 The sinus venosus represent the venous end of the heart It receives 3 veins: 1- Common cardinal vein body wall 2- Umbilical vein from placenta 3- Vitelline vein from yolk sac 3 However!!!!! The left
More informationA STUDY OF MORPHOLOGY AND VARIATIONS OF LUNGS IN ADULTS AND FOETUS
International Journal of Advancements in Research & Technology, Volume 3, Issue 4, April-2014 150 A STUDY OF MORPHOLOGY AND VARIATIONS OF LUNGS IN ADULTS AND FOETUS ZAREENA.SK (assistant professor of anatomy)
More informationSitus inversus. Dr praveena pulmonology- final year post graduate
Situs inversus Dr praveena pulmonology- final year post graduate Definiton History Types Cause Clinical features Diagnosis Treatment Definition The term situs inversus is a short form of the latin phrase
More informationAssignable revenue codes: Explanation of services:
computed tomography Chest/Cardiac Assignable revenue codes: Explanation of services: 0350 CT Scan General Classification 0351 CT Scan Head Scan 0352 CT Scan Body Scan 0359 CT Scan Other CT Scans Known
More informationCORONARY arteriovenous fistulas are uncommon, but their detection has. Rupture of a Giant Saccular Aneurysm of Coronary Arteriovenous Fistulas
Rupture of a Giant Saccular Aneurysm of Coronary Arteriovenous Fistulas Masahiro ITO, MD, Makoto KODAMA, MD, Makihiko SAEKI, 1 MD, Hiroshi FUKUNAGA, MD, Tomoji GOTO, 2 MD, Hidenori INOUE, 2 MD, Shigetaka
More informationCyanosis and Pulmonary Disease in Infancy
CLINICAL CONFERENCE Cyanosis and Pulmonary Disease in Infancy By Robert A. Miller, M.D. Division of Cardiology, Children s Memorial Hospital, and the Department of Pediatrics, Northwestern University Medical
More informationSurgical Management Of TAPVR. Daniel A. Velez, M.D. Congenital Cardiac Surgeon Phoenix Children s Hospital
Surgical Management Of TAPVR Daniel A. Velez, M.D. Congenital Cardiac Surgeon Phoenix Children s Hospital No Disclosures Goals Review the embryology and anatomy Review Surgical Strategies for repair Discuss
More informationBronchiectasis: An Imaging Approach
Bronchiectasis: An Imaging Approach Travis S Henry, MD Associate Professor of Clinical Radiology Cardiac and Pulmonary Imaging Section University of California, San Francisco Large Middle Small 1 Bronchiectasis
More informationThe Chest X-ray for Cardiologists
Mayo Clinic & British Cardiovascular Society at the Royal College of Physicians, London : 21-23-October 2013 Cases-Controversies-Updates 2013 The Chest X-ray for Cardiologists Michael Rubens Royal Brompton
More informationVariations of pulmonary vein drainage critical for lung resection assessed by three-dimensional computed tomography angiography
Thoracic Cancer ISSN 1759-7706 ORIGINAL ARTICLE Variations of pulmonary vein drainage critical for lung resection assessed by three-dimensional computed tomography angiography Nobuyuki Shiina 1, Kichizo
More informationAortography in Fallot's Tetralogy and Variants
Brit. Heart J., 1969, 31, 146. Aortography in Fallot's Tetralogy and Variants SIMON REES AND JANE SOMERVILLE From The Institute of Cardiology and National Heart Hospital, London W.J In patients with Fallot's
More informationCésar Abelleira. Hospital Ramón y Cajal. Madrid
INTERVENTIONAL TREATMENT OF HEMOPTYSIS IN THE CYANOTIC PATIENT César Abelleira. Hospital Ramón y Cajal. Madrid Hemoptysis Blood expectoration from lungs. Infrequent Very traumatic for patient Life-threatening
More informationAnatomical Segmentectomy with a Hybrid VATS Approach in a Patient with Intralobar Pulmonary Sequestration after Severe Pneumonia: A Case Report
THIEME Case Report e21 Anatomical Segmentectomy with a Hybrid VATS Approach in a Patient with Intralobar Pulmonary Sequestration after Severe Pneumonia: A Case Report Soichi Shibuya 1,2 Toru Nakamura 3
More informationDivision of Diagnostic Imaging, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
89 Lymphology 28 (1995) 89-94 Division of Diagnostic Imaging, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA ABSTRACT The anatomy of the posterior intercostal lymphatics and lymph
More informationAORTIC COARCTATION. Synonyms: - Coarctation of the aorta
AORTIC COARCTATION Synonyms: - Coarctation of the aorta Definition: Aortic coarctation is a congenital narrowing of the aorta, usually located after the left subclavian artery, near the ductus or the ligamentum
More informationCardiopulmonary Syndromes: Conditions With Concomitant Cardiac and Pulmonary Abnormalities
Cardiopulmonary Syndromes: Conditions With Concomitant Cardiac and Pulmonary Abnormalities Carlos S. Restrepo M.D. Professor of Radiology The University of Texas HSC at San Antonio Cardiopulmonary Syndromes
More informationPulmonary vascular anomalies in adult; a pictorial review
Pulmonary vascular anomalies in adult; a pictorial review Award: Magna Cum Laude Poster No.: C-0901 Congress: ECR 2015 Type: Educational Exhibit Authors: K. Tokunaga, T. Yamaoka, A. Hamada, T. Kubo, K.
More informationLecturer: Ms DS Pillay ROOM 2P24 25 February 2013
Lecturer: Ms DS Pillay ROOM 2P24 25 February 2013 Thoracic Wall Consists of thoracic cage Muscle Fascia Thoracic Cavity 3 Compartments of the Thorax (Great Vessels) (Heart) Superior thoracic aperture
More informationAberrant Right Subclavian Artery Aneurysm
Aberrant Right Subclavian Artery William S. Stoney, M.D., William C. Alford, Jr., M.D., George R. Burrus, M.D., and Clarence S. Thomas, Jr., M.D. ABSTRACT Ten patients with aneurysm of an aberrant right
More informationAsymptomatic Primary Isolated Pulmonary Vein Stenosis in an Adult: A Case Report 1
Asymptomatic Primary Isolated Pulmonary Vein Stenosis in an Adult: A Case Report 1 Ji Hyun Kim, M.D., Ho Sung Lee, M.D., Jae Sung Choi, M.D., Ju Ock Na, M.D., Yong Hoon Kim, M.D., Sung Shick Jou, M.D.
More informationJae Hoon Lim, M.D., Song Choi, M.D. 2, Yang Jun Kang, M.D. 2, Hyun Ju Seon, M.D., Yun Hyeon Kim, M.D.
J Korean Soc Radiol 2010;62:113-117 The Noninvasive Diagnosis and Postoperative Evaluation of nomalous Right Coronary rtery from the Pulmonary rtery (RCP) using Coronary MDCT: Case Report 1 Jae Hoon Lim,
More informationTHE GOOFY ANATOMIST QUIZZES
THE GOOFY ANATOMIST QUIZZES 7. LUNGS Q1. Fill in the blanks: the lung has lobes and fissures. A. Right, three, two. B. Right, two, one. C. Left, three, two. D. Left, two, three. Q2. The base of the lung
More informationBronchogenic Carcinoma
A 55-year-old construction worker has smoked 2 packs of ciggarettes daily for the past 25 years. He notes swelling in his upper extremity & face, along with dilated veins in this region. What is the most
More informationInfradiaphragmatic Total Anomalous Pulmonary Venous Return
Infradiaphragmatic Total Anomalous Pulmonary Venous Return Report of a New and Correctable Variant J. Kent Trinkle, M.D., Gordon K. Danielson, M.D., Jacqueline A. Noonan, M.D., and Charles Stephens, M.D.
More informationPortal vein catheterization and selective angiography in diagnosis of total anomalous pulmonary venous connexion
British Heart journal, 974, 36, 155-59. Portal vein catheterization and selective angiography in diagnosis of total anomalous pulmonary venous connexion Michael Tynan, D. Behrendt, W. Urquhart, and G.
More informationThoracoscopic S 6 segmentectomy: tricks to know
Surgical Technique Page 1 of 6 Thoracoscopic S 6 segmentectomy: tricks to know Agathe Seguin-Givelet 1,2, Jon Lutz 1, Dominique Gossot 1 1 Thoracic Department, Institut Mutualiste Montsouris, Paris, France;
More informationAnatomic variants of the normal coronary artery circulation
Diagnosis and Operation for Anomalous Circumflex Coronary Artery Keishi Ueyama, MD, PhD, Mahesh Ramchandani, MD, Arthur C. Beall, Jr, MD, and James W. Jones, MD, PhD Department of Surgery, Baylor College
More informationCardiac Radiology In-Training Test Questions for Diagnostic Radiology Residents
Cardiac Radiology In-Training Test Questions for Diagnostic Radiology Residents March, 2013 Sponsored by: Commission on Education Committee on Residency Training in Diagnostic Radiology 2013 by American
More informationLarge veins of the thorax Brachiocephalic veins
Large veins of the thorax Brachiocephalic veins Right brachiocephalic vein: formed at the root of the neck by the union of the right subclavian & the right internal jugular veins. Left brachiocephalic
More informationCongenital Absence of the Right Pulmonary Artery: Four Cases Report
Chin J Radiol 2004; 29: 35-40 35 Congenital Absence of the Right Pulmonary Artery: Four Cases Report CHUN-HO YUN CHIN-YIN SHEU SHIN-LIN SHIH Department of Radiology, Mackay Memorial Hospital is an uncommon
More informationIndex. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Acute coronary syndrome(s), anticoagulant therapy in, 706, 707 antiplatelet therapy in, 702 ß-blockers in, 703 cardiac biomarkers in,
More informationDEVELOPMENT OF THE CIRCULATORY SYSTEM L E C T U R E 5
DEVELOPMENT OF THE CIRCULATORY SYSTEM L E C T U R E 5 REVIEW OF CARDIAC ANATOMY Heart 4 chambers Base and apex Valves Pericardial sac 3 layers: epi, myo, endo cardium Major blood vessels Aorta and its
More informationExtralobar lung sequestration associated with fatal
Thorax (1971), 26, 125. Extralobar lung sequestration associated with fatal neonatal respiratory distress A. J. BLIEK and D. J. MULHOLLAND The Departments of Radiology and Pathology, Royal Alexandra Hospital,
More informationSyllabus: 6 pages (Page 6 lists corresponding figures for Grant's Atlas 11 th & 12 th Eds.)
PLEURAL CAVITY AND LUNGS Dr. Milton M. Sholley SELF STUDY RESOURCES Essential Clinical Anatomy 3 rd ed. (ECA): pp. 70 81 Syllabus: 6 pages (Page 6 lists corresponding figures for Grant's Atlas 11 th &
More informationRobotic-assisted right inferior lobectomy
Robotic Thoracic Surgery Column Page 1 of 6 Robotic-assisted right inferior lobectomy Shiguang Xu, Tong Wang, Wei Xu, Xingchi Liu, Bo Li, Shumin Wang Department of Thoracic Surgery, Northern Hospital,
More informationChapter 2 Cardiac Interpretation of Pediatric Chest X-Ray
Chapter 2 Cardiac Interpretation of Pediatric Chest X-Ray Ra-id Abdulla and Douglas M. Luxenberg Key Facts The cardiac silhouette occupies 50 55% of the chest width on an anterior posterior chest X-ray
More informationRobotic-assisted left inferior lobectomy
Robotic Thoracic Surgery Column Robotic-assisted left inferior lobectomy Shiguang Xu, Hao Meng, Tong Wang, Wei Xu, Xingchi Liu, Shumin Wang Department of Thoracic Surgery, Northern Hospital, Shenyang 110015,
More informationThe branching pattern of pulmonary vessels varies
GENERAL THORACIC Right Upper Lobe Venous Drainage Posterior to the Bronchus Intermedius: Preoperative Identification by Computed Tomography Katsuyuki Asai, MD, Norikazu Urabe, MD, PhD, Kiyoshige Yajima,
More informationManagement of the persistent sciatic artery with coexistent aortoiliac aneurysms; endovascular and open techniques.
ISPUB.COM The Internet Journal of Thoracic and Cardiovascular Surgery Volume 14 Number 2 Management of the persistent sciatic artery with coexistent aortoiliac aneurysms; endovascular and open A Rodriguez-Rivera,
More informationAssignable revenue codes: Explanation of services:
COMPUTED TOMOGRAPHY Chest/Cardiac Assignable revenue codes: 0350 CT Scan General Classification 0351 CT Scan Head Scan 0352 CT Scan Body Scan 0359 CT Scan Other CT Scans Explanation of services: Known
More informationRadiological Anatomy of Thorax. Dr. Jamila Elmedany & Prof. Saeed Abuel Makarem
Radiological Anatomy of Thorax Dr. Jamila Elmedany & Prof. Saeed Abuel Makarem Indications for Chest x - A chest x-ray may be used to diagnose and plan treatment for various conditions, including: Diseases/Fractures
More informationSETTING Fudan University Shanghai Cancer Center. RESPONSIBLE PARTY Haiquan Chen MD.
OFFICIAL TITLE A Phase Ⅲ Study of Left Side Thoracotomy Approach (SweetProcedure) Versus Right Side Thoracotomy Plus Midline Laparotomy Approach (Ivor-Lewis Procedure) Esophagectomy in Middle or Lower
More informationBronchioles. Alveoli. Type I alveolar cells are very thin simple squamous epithelial cells and form most of the lining of an alveolus.
276 Bronchioles Bronchioles continue on to form bronchi. The primary identifying feature is the loss of hyaline cartilage. The epithelium has become simple ciliated columnar, and there is a complete ring
More informationCase Report Preoperative Assessment of Anomalous Right Coronary Artery Arising from the Main Pulmonary Artery
Case Reports in Medicine Volume 2011, Article ID 642126, 4 pages doi:10.1155/2011/642126 Case Report Preoperative Assessment of Anomalous Right Coronary Artery Arising from the Main Pulmonary Artery Marshall
More informationCoronary Arteriovenous Malformation presenting as Acute Myocardial Infarction. Choon Ta NG, Aaron WONG, Foong-Koon CHEAH, Chi Keong CHING
Coronary Arteriovenous Malformation presenting as Acute Myocardial Infarction Choon Ta NG, Aaron WONG, Foong-Koon CHEAH, Chi Keong CHING The patient 49 year old Male presented with Chest tightness x 1
More informationAberrant Right Subclavian Artery
A Doubtful Cause of Symptoms Thomas P. Comer, M.D., Malvin Weinberger, M.D., and Howard D. Sirak, M.D. ABSTRACT Ten patients with surgically treated aberrant right subclavian artery are reviewed. In half,
More informationHOW TO IMAGE AND DESCRIBE CONGENITAL LUNG MALFORMATIONS
HOW TO IMAGE AND DESCRIBE CONGENITAL LUNG MALFORMATIONS Paul Thacker, MD Assistant Professor Departments of Radiology and Pediatrics Medical University of South Carolina DISCLOSURES I have no relevant
More informationRadiology of the respiratory/cardiac diseases (part 2)
Cardiology Cycle - Lecture 6 436 Teams Radiology of the respiratory/cardiac diseases (part 2) Objectives Done By Team Leaders: Khalid Alshehri Hanin Bashaikh Team Members: Leena Alwakeel Aroob Alhuthail
More informationDo you want to be an excellent Radiologist? - Focus on the thoracic aorta on lateral chest image!!!
The lateral chest radiograph: Challenging area around the thoracic aorta!!! Do you want to be an excellent Radiologist? - Focus on the thoracic aorta on lateral chest image!!! Dong Yoon Han 1, So Youn
More information8/14/2017. Objective: correlate radiographic findings of common lung diseases to actual lung pathologic features
What is that lung disease? Pulmonary Patterns & Correlated Pathology Dr. Russell Tucker, DACVR Objective: correlate radiographic findings of common lung diseases to actual lung pathologic features Improved
More informationTotal Anomalous Pulmonary Venous Connections: Anatomy and Diagnostic Imaging
Total Anomalous Pulmonary Venous Connections: Anatomy and Diagnostic Imaging Timothy Slesnick, MD March 12, 2015 Congenital Cardiac Anesthesia Society Annual Meeting Disclosures I will discuss the use
More informationAccomplishes fundamental surgical tenets of R0 resection with systematic nodal staging for NSCLC Equivalent survival for Stage 1A disease
Segmentectomy Made Simple Matthew J. Schuchert and Rodney J. Landreneau Department of Cardiothoracic Surgery University of Pittsburgh Medical Center Financial Disclosures none Why Consider Anatomic Segmentectomy?
More informationResearch Article Variations in Draining Patterns of Right Pulmonary Veins at the Hilum and an Anatomical Classification
International Scholarly Research Network ISRN Pulmonology Volume 0, Article ID 7869, pages doi:0.0/0/7869 Research Article Variations in Draining Patterns of Right Pulmonary Veins at the Hilum and an Anatomical
More informationAPICAL SEGMENT OF THE LOWER LOBE IN RESECTIONS FOR BRONCHIECTASIS
Thorax (1955), 10, 137. THE LATE RESULTS OF THE CONSERVATION OF THE APICAL SEGMENT OF THE LOWER LOBE IN RESECTIONS FOR BRONCHIECTASIS BY E. HOFFMAN From the Regional Thoracic Surgery Centre, Shotley Bridge
More informationCongenital Heart Defects
Normal Heart Congenital Heart Defects 1. Patent Ductus Arteriosus The ductus arteriosus connects the main pulmonary artery to the aorta. In utero, it allows the blood leaving the right ventricle to bypass
More informationLow-dose prospective ECG-triggering dual-source CT angiography in infants and children with complex congenital heart disease: first experience
Low-dose prospective ECG-triggering dual-source CT angiography in infants and children with complex congenital heart disease: first experience Ximing Wang, M.D., Zhaoping Cheng, M.D., Dawei Wu, M.D., Lebin
More informationPathophysiology: Left To Right Shunts
Pathophysiology: Left To Right Shunts Daphne T. Hsu, MD dh17@columbia.edu Learning Objectives Learn the relationships between pressure, blood flow, and resistance Review the transition from fetal to mature
More informationOriginal Article. Double Aortic Arch in Infants and Children CH XIE, FQ GONG, GP JIANG, SL FU. Key words. Background
HK J Paediatr (new series) 2018;23:233-238 Original Article Double Aortic Arch in Infants and Children CH XIE, FQ GONG, GP JIANG, SL FU Abstract Key words Background: This study aimed to report the diagnosis,
More informationLung Perfusion Analysis New Pathways in Lung Imaging. Case Study Brochure PLA 309 Hospital
Lung Perfusion Analysis New Pathways in Lung Imaging Case Study Brochure PLA 309 Hospital http://www.toshibamedicalsystems.com Toshiba Medical Systems Corporation 2012 all rights reserved. Design and specifications
More informationDescending aorta replacement through median sternotomy
Descending aorta replacement through median sternotomy Mitrev Z, Anguseva T, Belostotckij V, Hristov N. Special hospital for surgery Filip Vtori Skopje - Makedonija June, 2010 Cardiosurgery - Skopje 1
More informationFOR CMS (MEDICARE) MEMBERS ONLY NATIONAL COVERAGE DETERMINATION (NCD) FOR COMPUTED TOMOGRAPHY:
National Imaging Associates, Inc. Clinical guidelines CHEST CTA Original Date: September 1997 Page 1 of 5 CPT Codes: 71275 Last Review Date: August 2014 NCD 220.1 Last Effective Date: March 2008 Guideline
More informationClinical presentation and characteristics of 25 adult cases of pulmonary sequestration
Original Article Clinical presentation and characteristics of 25 adult cases of pulmonary sequestration Mateusz Polaczek 1,2, Inga Baranska 3, Malgorzata Szolkowska 4, Jacek Zych 1, Piotr Rudzinski 5,
More information