Hybrid surgery for intralobar pulmonary sequestration with aortic aneurysm

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Medical Imaging

Background:

• Pulmonary sequestration (PS) is a rare congenital lung malformation.
• Intralobar pulmonary sequestration (IPS) can present with complex vascular and cardiovascular complications.
• Concurrent aortic aneurysmal dilation requires integrated treatment strategies.

Observation:

• A 62-year-old male patient presented with symptoms necessitating workup for pulmonary sequestration.
• Enhanced computed tomography (CT) identified intralobar pulmonary sequestration in the left lower lobe.
• Aortic aneurysmal dilation was noted at the origin of the aberrant feeding artery supplying the IPS.

Findings:

• A hybrid surgical procedure was successfully performed.
• The operation integrated thoracic endovascular aortic repair (TEVAR) with video-assisted thoracic surgery (VATS) for IPS excision.
• The patient's IPS and left lower lobe were successfully removed.

Implications:

• Hybrid approaches offer a viable solution for complex cases involving both pulmonary sequestration and aortic pathology.
• Minimally invasive techniques like TEVAR and VATS can improve patient recovery and reduce complications.
• This case highlights the importance of comprehensive imaging and tailored surgical planning for rare congenital conditions.