Successful Concomitant Thoracic Endovascular Aortic Repair and Lobectomy for Pulmonary Sequestration

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Medical Imaging

Background:

• Pulmonary sequestration is a rare congenital lung malformation.
• Aberrant systemic arterial supply, especially aneurysmal, presents significant surgical challenges.
• Early diagnosis via enhanced computed tomography (CT) is crucial for effective management.

Observation:

• A 60-year-old male presented with a right lower lobe pulmonary sequestration.
• Two aberrant systemic arteries were identified, one markedly aneurysmal and thrombosed.
• The patient had no prior history of recurrent pneumonia.

Findings:

• A hybrid operation combined thoracic endovascular stent graft implantation with right lower lobectomy.
• Aberrant arteries were successfully ligated using an endoscopic stapler.
• The patient experienced no postoperative complications and was discharged on day 6.

Implications:

• This hybrid approach offers a viable solution for complex pulmonary sequestration with aberrant vasculature.
• Minimally invasive techniques can reduce patient recovery time and complications.
• Long-term follow-up CT demonstrated successful arterial stump shrinkage, indicating effective treatment.