Bifurcation or periphery: Where should aberrant arteries in pulmonary sequestration be divided?

Introduction: Whether aberrant arteries in pulmonary sequestration should be divided at the bifurcation or at the periphery remains a subject of debate (Kodama et al., 2016). Due to the risk of postoperative aneurysm formation followed by fetal bleeding (Rubin et al., 1994), it is thought that the aberrant artery should be divided at the bifurcation in cases of pulmonary sequestration.

Presentation Of Case: A 35-year-old woman was referred to our hospital with continuous cough. Enhanced computed tomography (CT) subsequently revealed an infiltrative appearance in the right lower lobe of the lung, with an aberrant artery that originated from the left gastric artery and flowed into the right lower lobe of the lung. The aberrant artery was divided at the pulmonary ligament level; right lower lobectomy was performed. Enhanced CT performed four months postoperatively revealed that the residual region of the aberrant artery was spontaneously occluded.

Discussion: Although aberrant arteries are generally resected at their bifurcations, the present case suggests that dividing at the bifurcation might not be necessary. Alternatively, there may be characteristics that make resection at the bifurcation unnecessary.

Conclusion: Herein, we present a case wherein the residual aberrant artery was spontaneously occluded following resection of pulmonary sequestration.