Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.
Department of Pathology, Teikyo University School of Medicine, Tokyo, Japan.
Ann Thorac Cardiovasc Surg. 2024 Jan 26;30(1). doi: 10.5761/atcs.cr.23-00023. Epub 2023 Mar 15.
Systemic arterial blood supply to a normal lung is a rare anatomical abnormality. Surgery is usually indicated because this abnormality leads to pulmonary hypertension. Herein, we report our experience and ideas for safe vessel dissection. Case 1 was a woman in her 50s. We performed a left lower lobectomy following percutaneous coil embolization. The aberrant artery with emboli was confirmed intraoperatively by cone-beam computed tomography (CBCT) to safely dissect under thoracoscopic surgery (TS). Case 2 was a man in his 40s. Following percutaneous endovascular plug occlusion, we performed a left partial resection using indocyanine green fluorescence navigation. Intraoperatively, CBCT imaging demonstrated the aberrant artery and exact position of the emboli. This combination technique of interventional radiology and TS with CBCT imaging was considered safe and more secure for the treatment of anomalous systemic arterial blood supply to a normal lung.
正常肺的体循环动脉血供是一种罕见的解剖学异常。由于这种异常会导致肺动脉高压，因此通常需要手术治疗。在此，我们报告我们在安全血管解剖方面的经验和思路。病例 1 为 50 多岁女性，先行经皮线圈栓塞后行左下肺叶切除术。术中通过锥形束 CT（CBCT）证实存在带栓子的异常动脉，可在胸腔镜手术（TS）下安全解剖。病例 2 为 40 多岁男性，经皮腔内血管封堵后，行吲哚菁绿荧光导航下左肺部分切除术。术中 CBCT 成像显示了异常动脉和栓子的确切位置。对于治疗正常肺的体循环动脉异常血供，介入放射学和 CBCT 成像引导下的 TS 联合技术被认为是安全且更可靠的。
