Aneurysmal artery supplying pulmonary sequestration: successful combined approach

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Vascular Surgery

Background:

• Intralobar pulmonary sequestration is a rare congenital lung malformation.
• Aberrant arterial supply from the aorta can complicate surgical management.
• Endovascular techniques offer potential for minimally invasive treatment of vascular anomalies.

Purpose of the Study:

• To describe a novel combined endovascular and minimally invasive surgical approach.
• To manage an intralobar pulmonary sequestration with an aneurysmal feeding artery from the descending aorta.
• To evaluate the safety and efficacy of this hybrid strategy.

Main Methods:

• A 62-year-old male patient with asymptomatic intralobar pulmonary sequestration was treated.
• Thoracic endovascular aneurysm repair (TEVAR) was performed to exclude the aneurysmal aberrant artery.
• A triportal video-assisted left lower lobectomy was subsequently carried out.

Main Results:

• TEVAR successfully excluded the aberrant vessel without complications.
• The pulmonary resection was safely completed using a minimally invasive video-assisted approach.
• This combined technique minimized bleeding risk and facilitated a less invasive procedure.

Conclusions:

• Combined TEVAR and video-assisted lobectomy is a viable and safe approach for managing pulmonary sequestration with aortic arterial supply.
• This hybrid strategy offers a minimally invasive alternative to traditional open surgery.
• It effectively reduces operative risks, particularly bleeding, in complex cases.