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Vascular Anatomy in Congenital Lung Lesions—Description and Classification
BACKGROUND: Bronchopulmonary sequestration (BPS) and hybrid lesion of congenital pulmonary airway malformation (CPAM) are congenital lung lesions typically presenting with systemic vascular connection. We describe and categorize this atypical systemic vascular anatomy in congenital lung lesions. MET...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9135351/ https://www.ncbi.nlm.nih.gov/pubmed/35633957 http://dx.doi.org/10.3389/fped.2022.900538 |
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author | Kargl, Simon Schlader, Florian Scala, Mario Kammel, Julian |
author_facet | Kargl, Simon Schlader, Florian Scala, Mario Kammel, Julian |
author_sort | Kargl, Simon |
collection | PubMed |
description | BACKGROUND: Bronchopulmonary sequestration (BPS) and hybrid lesion of congenital pulmonary airway malformation (CPAM) are congenital lung lesions typically presenting with systemic vascular connection. We describe and categorize this atypical systemic vascular anatomy in congenital lung lesions. METHODS: In a medical chart review from 2005 to 2020 patients with systemic vascular connection of congenital lung lesions were identified. Clinical and radiological data were collected and compared. Two experienced pediatric radiologists reviewed postnatal thoracic contrast-enhanced computed tomography scans to describe and categorize atypical vascular anatomy. We completed our findings with a review on vascular anatomy in congenital lung lesions. RESULTS: A total of 21 patients with congenital lung lesions (nine extralobar BPS, five intralobar BPS, seven hybrid lesions) had systemic arterial supply; with seven of these additionally having systemic venous drainage. Origin of the feeding arteries from the aorta or aortic main branches was described as supra-diaphragmatic (descending thoracic aorta) in nine and infra-diaphragmatic in ten patients (abdominal aorta, celiac trunk). In two patients with hybrid lesions both supra- and infra-diaphragmatic arterial feeders were found. Additional systemic venous connection of supra-diaphragmatic type drains into the azygos-hemiazygos system (4/21) while the infra-diaphragmatic type (3/21) drains into caval vein, portal or splenic vein. CONCLUSION: Various variants of systemic arterial and venous connection of congenital lung lesions can be found. Classification of systemic arterial connection as well as venous drainage of congenital lung lesions as supra-diaphragmatic and infra-diaphragmatic types is intuitive, simple and may be important for the surgeon to avoid unanticipated situations and to perform safe resections. |
format | Online Article Text |
id | pubmed-9135351 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-91353512022-05-27 Vascular Anatomy in Congenital Lung Lesions—Description and Classification Kargl, Simon Schlader, Florian Scala, Mario Kammel, Julian Front Pediatr Pediatrics BACKGROUND: Bronchopulmonary sequestration (BPS) and hybrid lesion of congenital pulmonary airway malformation (CPAM) are congenital lung lesions typically presenting with systemic vascular connection. We describe and categorize this atypical systemic vascular anatomy in congenital lung lesions. METHODS: In a medical chart review from 2005 to 2020 patients with systemic vascular connection of congenital lung lesions were identified. Clinical and radiological data were collected and compared. Two experienced pediatric radiologists reviewed postnatal thoracic contrast-enhanced computed tomography scans to describe and categorize atypical vascular anatomy. We completed our findings with a review on vascular anatomy in congenital lung lesions. RESULTS: A total of 21 patients with congenital lung lesions (nine extralobar BPS, five intralobar BPS, seven hybrid lesions) had systemic arterial supply; with seven of these additionally having systemic venous drainage. Origin of the feeding arteries from the aorta or aortic main branches was described as supra-diaphragmatic (descending thoracic aorta) in nine and infra-diaphragmatic in ten patients (abdominal aorta, celiac trunk). In two patients with hybrid lesions both supra- and infra-diaphragmatic arterial feeders were found. Additional systemic venous connection of supra-diaphragmatic type drains into the azygos-hemiazygos system (4/21) while the infra-diaphragmatic type (3/21) drains into caval vein, portal or splenic vein. CONCLUSION: Various variants of systemic arterial and venous connection of congenital lung lesions can be found. Classification of systemic arterial connection as well as venous drainage of congenital lung lesions as supra-diaphragmatic and infra-diaphragmatic types is intuitive, simple and may be important for the surgeon to avoid unanticipated situations and to perform safe resections. Frontiers Media S.A. 2022-05-12 /pmc/articles/PMC9135351/ /pubmed/35633957 http://dx.doi.org/10.3389/fped.2022.900538 Text en Copyright © 2022 Kargl, Schlader, Scala and Kammel. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pediatrics Kargl, Simon Schlader, Florian Scala, Mario Kammel, Julian Vascular Anatomy in Congenital Lung Lesions—Description and Classification |
title | Vascular Anatomy in Congenital Lung Lesions—Description and Classification |
title_full | Vascular Anatomy in Congenital Lung Lesions—Description and Classification |
title_fullStr | Vascular Anatomy in Congenital Lung Lesions—Description and Classification |
title_full_unstemmed | Vascular Anatomy in Congenital Lung Lesions—Description and Classification |
title_short | Vascular Anatomy in Congenital Lung Lesions—Description and Classification |
title_sort | vascular anatomy in congenital lung lesions—description and classification |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9135351/ https://www.ncbi.nlm.nih.gov/pubmed/35633957 http://dx.doi.org/10.3389/fped.2022.900538 |
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