Transpleural abdominal systemic artery-pulmonary artery anastomosis in patients with chronic pulmonary infection

Systemic-pulmonary artery anastomoses commonly occur in lung diseases characterized by inflammation and decreased pulmonary artery perfusion. Three cases are reported in which anastomotic branches arose within the abdomen and crossed the pleural space. Arteriography differentiated acquired abdominal systemic artery supply from that seen in sequestration. In each case an inferior phrenic artery was involved, and a tangle of anastomotic branches was present at the pleural surface. Intensive medical therapy prior to lobectomy may be indicated in such patients.