Vascular Anatomy in Congenital Lung Lesions—Description and Classification
BackgroundBronchopulmonary 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.Method...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-05-01
|
| Series: | Frontiers in Pediatrics |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2022.900538/full |
| _version_ | 1828748418794651648 |
|---|---|
| author | Simon Kargl Simon Kargl Florian Schlader Florian Schlader Mario Scala Mario Scala Julian Kammel |
| author_facet | Simon Kargl Simon Kargl Florian Schlader Florian Schlader Mario Scala Mario Scala Julian Kammel |
| author_sort | Simon Kargl |
| collection | DOAJ |
| description | BackgroundBronchopulmonary 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.MethodsIn 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.ResultsA 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.ConclusionVarious 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. |
| first_indexed | 2024-04-14T05:01:58Z |
| format | Article |
| id | doaj.art-c882d4da742e40a48ff17966492c9921 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-04-14T05:01:58Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-c882d4da742e40a48ff17966492c99212022-12-22T02:10:54ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602022-05-011010.3389/fped.2022.900538900538Vascular Anatomy in Congenital Lung Lesions—Description and ClassificationSimon Kargl0Simon Kargl1Florian Schlader2Florian Schlader3Mario Scala4Mario Scala5Julian Kammel6Medical Faculty, Johannes Kepler University Linz, Linz, AustriaDepartment of Pediatric Surgery, Kepler University Hospital, Linz, AustriaMedical Faculty, Johannes Kepler University Linz, Linz, AustriaDepartment of Pediatric Surgery, Kepler University Hospital, Linz, AustriaMedical Faculty, Johannes Kepler University Linz, Linz, AustriaCompetence Center for Pediatric Radiology, Kepler University Hospital, Linz, AustriaCompetence Center for Pediatric Radiology, Kepler University Hospital, Linz, AustriaBackgroundBronchopulmonary 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.MethodsIn 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.ResultsA 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.ConclusionVarious 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.https://www.frontiersin.org/articles/10.3389/fped.2022.900538/fullcongenital pulmonary lesionvascular anatomybronchopulmonary sequestrationhybrid lesioncongenital pulmonary airway malformation |
| spellingShingle | Simon Kargl Simon Kargl Florian Schlader Florian Schlader Mario Scala Mario Scala Julian Kammel Vascular Anatomy in Congenital Lung Lesions—Description and Classification Frontiers in Pediatrics congenital pulmonary lesion vascular anatomy bronchopulmonary sequestration hybrid lesion congenital pulmonary airway malformation |
| 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 | congenital pulmonary lesion vascular anatomy bronchopulmonary sequestration hybrid lesion congenital pulmonary airway malformation |
| url | https://www.frontiersin.org/articles/10.3389/fped.2022.900538/full |
| work_keys_str_mv | AT simonkargl vascularanatomyincongenitallunglesionsdescriptionandclassification AT simonkargl vascularanatomyincongenitallunglesionsdescriptionandclassification AT florianschlader vascularanatomyincongenitallunglesionsdescriptionandclassification AT florianschlader vascularanatomyincongenitallunglesionsdescriptionandclassification AT marioscala vascularanatomyincongenitallunglesionsdescriptionandclassification AT marioscala vascularanatomyincongenitallunglesionsdescriptionandclassification AT juliankammel vascularanatomyincongenitallunglesionsdescriptionandclassification |