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

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.