Two unusual variants of pulmonary intra-lobar sequestration

Area of Science:

• Cardiothoracic Surgery
• Congenital Malformations
• Vascular Anatomy

Background:

• Pulmonary sequestration involves non-functional lung tissue with abnormal systemic arterial supply and bronchial connection.
• Recurrent infections are common, complicating surgical interventions.
• Anatomical variations necessitate precise preoperative radiological assessment for optimal surgical planning.

Purpose of the Study:

• To report on two adult cases of intralobar pulmonary sequestration with rare aberrant vascular anatomy.
• To discuss surgical and hybrid treatment approaches for complex pulmonary sequestration.
• To highlight the challenges associated with preoperative embolization in hybrid procedures.

Main Methods:

• Surgical resection was performed in both adult patients with intralobar pulmonary sequestration.
• A hybrid approach, combining embolization and surgery, was utilized in one patient.
• High-quality preoperative radiological imaging was crucial for surgical planning.

Main Results:

• Both patients were successfully treated with surgical intervention.
• The hybrid approach presented peroperative challenges due to coil exposure from embolization.
• Aberrant vascular anatomy posed technical difficulties during the hybrid procedure.

Conclusions:

• Surgical management remains the gold standard for operable pulmonary sequestration.
• Preoperative embolization, while reducing hemorrhage risk, can introduce technical complexities in hybrid procedures.
• Careful preoperative evaluation and tailored surgical strategies are essential for managing rare pulmonary sequestration cases.