Departmant of Thoracic Surgery, National Defense Medical College, 3-2, Namiki, Tokorozawa, Saitama, 359-8513, Japan.
Department of Thoracic Surgery, Tokorozawa-Meisei Hospital, 5095, Yamaguchi, Tokorozawa, Saitama, 359-1145, Japan.
J Cardiothorac Surg. 2022 Apr 27;17(1):86. doi: 10.1186/s13019-022-01837-3.
A mediastinal mediobasal segmental pulmonary artery (A7) from the right main pulmonary artery is extremely rare.
We report the case of a 71-year-old woman with an aberrant mediastinal A7 who underwent right lower lobectomy for lung cancer (cT1bN0M0, stage IA2). Preoperative three-dimensional computed tomography (CT) angiography revealed an aberrant mediastinal A7 in the right main pulmonary artery. Right lower lobectomy and mediastinal lymph node dissection were performed. Intraoperatively, A7 was observed between the superior and inferior pulmonary veins and in the front of the lower bronchus near the anterior hilum. The artery was carefully dissected from the caudal side after inferior pulmonary vein dissection. The lung parenchyma, which was within the fissure due to poor lobulation between the middle and lower lobes, was safely divided.
Thoracic surgeons need to carefully evaluate CT angiography or enhanced multidetector CT findings at preoperative conferences and always keep this anomaly in mind.
发自右肺动脉主干的纵隔中基底段肺动脉（A7）极为罕见。
我们报告了一例 71 岁女性患者，其存在纵隔 A7 异常，因肺癌行右下肺叶切除术（cT1bN0M0，IA2 期）。术前三维 CT 血管造影显示右肺动脉主干存在纵隔 A7 异常。行右下肺叶切除术和纵隔淋巴结清扫术。术中发现 A7 位于上、下肺静脉之间，在下支气管前方，靠近前隆突。在完成下肺静脉解剖后，从尾侧仔细解剖动脉。由于中、下叶之间分叶不良，肺实质位于裂内，可安全地进行分隔。
胸外科医生需要在术前会议上仔细评估 CT 血管造影或增强多排 CT 的结果，并始终牢记这种异常。
