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Ann Thorac Surg 1999;68:332-338
© 1999 The Society of Thoracic Surgeons
a Department of Chest Surgery, Fukui Red Cross Hospital, Fukui, Japan
b Department of Respiratory Diseases, Fukui Red Cross Hospital, Fukui, Japan
c Department of Radiology and Pathology, Fukui Red Cross Hospital, Fukui, Japan
d Department of Fukui Red Cross Hospital, Fukui, Japan
Address reprint requests to Dr Yamanaka, Department of Chest Surgery, Fukui Red Cross Hospital, 2-4-1 Tsukimi, Fukui 918-8501, Japan
e-mail: akiray{at}mitene.or.jp
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.
Methods. 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. 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.
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.
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