Abstract
In thoracic surgery, anatomic variations of pulmonary artery increase the risks for vessel injury and critical mistakes during pulmonary artery resection. We report a case of lung cancer with an extremely rare branch, a mediastinal A7 pulmonary artery. Some case reports of the mediastinal pulmonary artery exist until now. However, to the best of our knowledge, this is the first case of a medial basal segmental artery (from the following, it is referred to as A7) branching directly from main pulmonary artery in the literature. Therefore, there is no report that showed three-dimensional computed tomography (3D-CT) and operative findings. So, these information is very useful for thoracic surgeon. A 67-year-old man was admitted to our hospital in order to undergo operation for the treatment of lung cancer. We detected the anomalies preoperatively by 3D-CT. The 3D-CT shows the A7 pulmonary artery branches from the right main pulmonary artery directly. According to previous literature, the cases of a single branch from main pulmonary artery to lower lobe are only five cases. And, the only two of them are right side including our case. In spite of an extremely rare case, we were able to successfully perform a right middle lobectomy because the information obtained from the 3D-CT findings was sufficiently understood preoperatively.
Highlights
Branching of the pulmonary artery, pulmonary vein and bronchus vary among individuals [1], and abnormal blood vessel and vascular branch are observed in rare cases
Sharing of this information with the team is important for the performance of safe surgery. Lowinvasive surgery, such as video-assisted thoracic surgery (VATS) and segmentectomy, is increasingly performed, and preoperative confirmation of the vascular branching is important in this surgery
Computed tomography (CT) and reconstructed vascular images from three-dimensional computed tomography (3D-CT) angiography are useful for this purpose [2, 3]
Summary
Branching of the pulmonary artery, pulmonary vein and bronchus vary among individuals [1], and abnormal blood vessel and vascular branch are observed in rare cases. Sharing of this information with the team is important for the performance of safe surgery. Lowinvasive surgery, such as video-assisted thoracic surgery (VATS) and segmentectomy, is increasingly performed, and preoperative confirmation of the vascular branching is important in this surgery. A7 branching from the right main pulmonary artery was observed during surgery, as detected on CT and 3D angiography (Fig. 1), and attention to the A7 was required during interlobular formation between the upper and middle lobes. The chest drain was removed on postoperative day 2, and the patient was
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
