Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Treatment of Systemic Arterial Supply to Lower Lobe of Left Lung (Operation vs. Embolotherapy): Comparison of Two Cases and Literature Review

좌측 하폐엽에 공급하는 비정상적인 체동맥의 치료 (수술과 색전술의 비교)

  • Jeon Eui-Yong (Department of Radiology, Hanil General Hospital, KEPCO Medical Foundation) ;
  • Rhee Gwang-Woo (Department of Radiology, Hanil General Hospital, KEPCO Medical Foundation) ;
  • Goo Dong-Erk (Department of Radiology, College of Medicine, Soonchunhyang University Hospital) ;
  • Kim Eung-Soo (Department of Thoracic and Cardiovascular Surgery, Hanil General Hospital, KEPCO Medical Foundation)
  • 전의용 (한진의료재단 한일병원 진단방사선과) ;
  • 이광우 (한진의료재단 한일병원 진단방사선과) ;
  • 구동억 (한진의료재단 한일병원 진단방사선과학교실) ;
  • 김응수 (한진의료재단 한일병원 흉부외과)
  • Published : 2006.03.01
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Abstract

Systemic arterialization of lung with/without sequestration (Sequestration/Anomalous Origin of Left Pulmonary Artery, AOLPA) is a rare form of congenital anomalous systemic arterial supply to the lungs. In this anomaly, the arterial supply of one or more arteries of the basal segments of the lower lobe derives from an aberrant vessel arising from the aorta. We report two adult cases of systemic arterialization of normal basal segments of left lower lobe lung with/without sequestration. The one (AOLPA) was treated by left lower basal segmentectomy and the other (Sequestration) by therapeutic angiographic embolization. Based on the favorable follow-up result in our patients, although lobectomy (segmentectomy) is the basic treatment modality, embolotherapy could also be a mode of treatment that could be selectively applied to elderly, infirm patients or high risk patients with poor pulmonary function.

폐에 체동맥이 분포하는 선천성 기형은 드문 질환으로 하폐엽의 기저분절에 폐동맥 대신 대동맥에서 1개 이상의 체동맥이 나오는데 정상적인 기관지와 연결 유무에 따라 폐 분획증과 좌측 폐동맥 이상 기시증(Anomalous Origin of Left Pulmonary Artery, AOLPA)으로 구분된다. 한일병원 흉부외과에서는 하행 흉부 대동맥에서 시작되는 비정상적인 체동맥을 가진 두 예의 폐동맥 기형을 경험하고, 1예는 기저분절절제술을, 다른 예는 동맥색전술을 시행하였고, 2년간 관찰한 결과 양호하였다. 이 결과를 바탕으로 외과적 수술이 이 기형의 근본적인 치료법이지만, 전신상태가 불량하거나 폐기능이 저하된 고위험군에서 동맥색전술도 선택적으로 시행할 수 있는 가능한 치료법으로 생각된다.

Keywords

References

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