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Ann Thorac Surg 1982;34:581-585
© 1982 The Society of Thoracic Surgeons

Articles

Pulmonary Sequestration Causing Congestive Heart Failure in Infancy: A Report of Two Cases and Review of the Literature

Marc M. Levine, M.D., Dov B. Nudel, M.D.*, Norman Gootman, M.D., Allan Wolpowitz, M.D., B. George Wisoff, M.D.

Division of Pediatric Cardiology, Department of Pediatrics and Division of Cardiothoracic Surgery, Department of Surgery, Long Island Jewish-Hillside Medical Center, New Hyde Park, and the Health Sciences Center, State University of New York, Stony Brook, NY.

Accepted for publication October 7, 1981.

* Address reprint requests to Dr. Nudel, Division of Pediatric Cardiology, Department of Pediatrics, Long Island Jewish-Hillside Medical Center, New Hyde Park, NY 11042.

Congestive heart failure as a presenting symptom in infants with pulmonary sequestration is rare, and the cases of only 3 such patients have been reported. The clinical features, hemodynamics, and management of two additional patients are described. Both were seen in severe congestive heart failure in the absence of any associated cardiac anomalies. The physical findings, plain roentgenograms, electrocardiograms, and echocardiograms may provide some diagnostic clues, but cardiac catheterization is the essential diagnostic investigation. In 1 patient, pneumonectomy was performed because of extensive changes throughout the affected lung. In the other, ligation of the anomalous systemic artery to the sequestered lobe was the only surgical procedure. Both patients are doing well 15 months and 18 months after operation. Success with the latter surgical approach has not been reported previously.




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