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      The aberrant systemic-pulmonary artery communication: three-dimensional image simulation

      case-report

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          Abstract

          Background

          Congenital arterial abnormalities are unusual causes of hemoptysis in elder patients. Appropriate image examination and recognition of the variant vessels are crucial in achieving precise diagnosis and successful treatment.

          Case presentation

          We report a case of 70-year-old female presenting with hemoptysis. Computed tomography angiography showed hypervascular lesions in the lingula of the left lung abutting the pericardium. Three-dimensional reconstruction image revealed an aberrant systemic arterial supply communicating with the left pulmonary artery and co-supplying the pulmonary parenchyma of the left upper. Single-port video-assisted thoracoscopic surgery with anomalous vessel ligation and lingual segmentectomy were performed smoothly. The symptom of hemoptysis subsided after operation with 2-year follow up.

          Conclusion

          An anomalous systemic arterial supply to the left upper lobe of the lung with an aberrant systemic system draining into the left pulmonary artery and co-supplying the lung parenchyma is extremely rare. Preoperative simulation with three-dimensional reconstruction image provides a clear spatial anatomy that allows clinicians to identify the orientation of the vessels more precisely when deciding on intervention.

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          Haemoptysis in adults: a 5-year study using the French nationwide hospital administrative database.

          Caroline Abdulmalak, Jonathan Cottenet, Guillaume Beltramo … (2015)
          Haemoptysis is a serious symptom with various aetiologies. Our aim was to define the aetiologies, outcomes and associations with lung cancer in the entire population of a high-income country.This retrospective multicentre study was based on the French nationwide hospital medical information database collected over 5 years (2008-2012). We analysed haemoptysis incidence, aetiologies, geographical and seasonal distribution and mortality. We studied recurrence, association with lung cancer and mortality in a 3-year follow-up analysis.Each year, ~15 000 adult patients (mean age 62 years, male/female ratio 2/1) were admitted for haemoptysis or had haemoptysis as a complication of their hospital stay, representing 0.2% of all hospitalised patients. Haemoptysis was cryptogenic in 50% of cases. The main aetiologies were respiratory infections (22%), lung cancer (17.4%), bronchiectasis (6.8%), pulmonary oedema (4.2%), anticoagulants (3.5%), tuberculosis (2.7%), pulmonary embolism (2.6%) and aspergillosis (1.1%). Among incident cases, the 3-year recurrence rate was 16.3%. Of the initial cryptogenic haemoptysis patients, 4% were diagnosed with lung cancer within 3 years. Mortality rates during the first stay and at 1 and 3 years were 9.2%, 21.6% and 27%, respectively.This is the first epidemiological study analysing haemoptysis and its outcomes in an entire population. Haemoptysis is a life-threatening symptom unveiling potentially life-threatening underlying conditions.
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            Anomalous systemic arterial supply to normal basal segments of the left lower lobe.

            Akira Yamanaka, Takashi Hirai, Toshio Fujimoto … (1999)
            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. The cases of all 4 patients who were treated surgically by us were reviewed together with 8 previously reported cases. 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. From 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. This anomaly is probably one type of sequestration complex. Both aortic and pulmonary arterial angiographic studies are needed to plan the definitive surgical procedure.
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              Systemic arterial supply to the normal basal segments of the left lower lobe treated by coil embolization, with long-term follow-up.

              Tsukasa Saida, Hiroki Ninomiya, Fumihiko Hojo … (2006)
              We report a case of a 41-year-old woman who underwent therapeutic embolization of an aberrant systemic artery of the lung. Except for chest pains immediately after embolization, she recovered well and has not experienced hemoptysis in the past 6 years. In such patients, coil embolization could be an alternative choice of treatment, with the expectation of an excellent long-term result despite ischemia of the corresponding lung parenchyma.
              Article 0 comments Cited 7 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Chun-Lin Kuo: c1995chris821@gmail.com
                Kuan-Hsun Lin: dontchangela@gmail.com
                Kai-Hsiung Ko: m860818@mail.ndmctsgh.edu.tw
                Tsai-Wang Huang: +886-2-87927167 , chi-wang@yahoo.com.tw
                Journal
                Journal ID (nlm-ta): J Cardiothorac Surg
                Journal ID (iso-abbrev): J Cardiothorac Surg
                Title: Journal of Cardiothoracic Surgery
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1749-8090
                Publication date (Electronic): 11 February 2019
                Publication date PMC-release: 11 February 2019
                Publication date Collection: 2019
                Volume: 14
                Electronic Location Identifier: 35
                Affiliations
                [1 ]ISNI 0000 0004 0634 0356, GRID grid.260565.2, Tri-Service General Hospital, , National Defense Medical Center, ; Taipei, Taiwan, Republic of China
                [2 ]Department of Surgery, Division of Thoracic Surgery, Tri-Service General Hospital, National Defense Medical Center, 325, Section 2, Cheng-Kung Road, Taipei, 114 Taiwan, Republic of China
                [3 ]Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
                Article
                Publisher ID: 855
                DOI: 10.1186/s13019-019-0855-5
                PMC ID: 6371447
                PubMed ID: 30744669
                SO-VID: 4b84dad1-3bff-47f8-9a83-86ea59dadaae
                Copyright © © The Author(s). 2019
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 9 December 2018
                Date accepted : 3 February 2019
                Categories
                Subject: Case Report
                Custom metadata
                issue-copyright-statement © The Author(s) 2019

                ScienceOpen disciplines: Surgery
                Keywords: hemoptysis,anomalous arterial supply,3-d image simulation
                Data availability:
                ScienceOpen disciplines: Surgery
                Keywords: hemoptysis, anomalous arterial supply, 3-d image simulation

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