Extrapulmonary sequestration with a left internal thoracic arterial feeding vessel in an infant treated with video-assisted Thoracoscopic resection: a case report

Journal of Cardiothoracic Surgery
Laura DiChiacchioJose Greenspon

Abstract

Congenital lung malformations exist along a spectrum of pathogenesis and disease severity. Extrapulmonary sequestration (EPS), in which nonfunctional lung tissue develops without connection to the tracheobronchial tree, is one rare manifestation of this disease. Atypical vascular anatomy with a systemic feeding vessel characterizes these lesions. A 3 day old, 37 week gestation infant underwent chest X-ray for confirmation of umbilical catheter placement and was found to have an elevated left hemidiaphragm consistent with eventration versus congenital diaphragmatic hernia. He remained asymptomatic and was evaluated as an outpatient at the age of 9 months, where CT angiogram demonstrated extrapulmonary versus intrapulmonary sequestration with a systemic feeding vessel from the left internal mammary artery. It is exceedingly rare for the feeding artery to arise from the internal mammary; two such cases have been reported to date, both in adult patients. Here we present a third case of EPS with arterial supply from the internal mammary successfully treated with video-assisted thoracoscopic resection in a 9 month old infant.

References

Jun 7, 2005·Journal of Pediatric Surgery·Curt S KoontzMark L Wulkan
May 9, 2007·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Caroline ReinkeHenry E Rice
Jun 15, 2007·Seminars in Respiratory and Critical Care Medicine·Ernst Eber
Dec 10, 2013·Journal of the American College of Surgeons·Shaun M KunisakiRonald B Hirschl
Jun 14, 2016·Journal of Pediatric Surgery·Amy E WagenaarEduardo A Perez
Jan 4, 2017·Pediatric Surgery International·Atsuyuki YamatakaKenji Suzuki

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