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Clinical benefits, echocardiographic and MRI assessment after pulmonary sequestration treatment

Francesco Borgia1, Francesca Santamaria2, Carmine Mollica3

  • 1Department of Advanced Biomedical Sciences, Divisions of Cardiology and Cardiothoracic Surgery, Federico II University, Naples, Italy.

International Journal of Cardiology
|May 13, 2017
PubMed

Insights

Percutaneous treatment for pulmonary sequestration (PS) in children is safe and effective, leading to symptom improvement and reduced heart enlargement. MRI confirms treatment success and monitors residual PS, aiding in long-term management.

Area of Science:

  • Pediatric Interventional Cardiology
  • Thoracic Imaging
  • Vascular Malformations

Background:

  • Pulmonary sequestration (PS) is a congenital lung malformation with potential for significant clinical impact.
  • Percutaneous treatment offers a minimally invasive approach to address the aberrant artery supplying PS.

Purpose of the Study:

  • To evaluate the procedural outcomes and clinical benefits of percutaneous treatment for pulmonary sequestration (PS).
  • To assess the efficacy of echocardiography and chest MRI in monitoring treatment effects on cardiac function and PS regression.

Main Methods:

  • A cohort of 13 infants and children with isolated PS underwent percutaneous closure of the aberrant feeding artery.
  • Echocardiography and chest MRI were performed pre- and post-treatment (6-12 months and 1 year) to assess cardiac volume overload and PS regression.

Main Results:

  • 100% procedural success was achieved in all patients.
  • Respiratory symptoms resolved post-treatment, with sustained asymptomatic status at a median follow-up of 2.9 years.
  • Significant reduction in cardiac chamber enlargement was observed in patients with shunts, confirmed by imaging at 6 and 12 months.
  • Chest MRI confirmed aberrant artery closure and PS regression in 12 patients; one case showed residual revascularization despite initial success.

Conclusions:

  • Percutaneous PS closure is a safe and effective treatment for infants and children, leading to symptom regression and improved cardiac function when shunts are present.
  • Chest MRI is a valuable tool for defining aberrant artery anatomy, assessing PS, and monitoring residual disease during patient growth.
Abstract

Keywords:
EmbolizationMRIPediatric cardiology

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