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Van Praagh R. Pulmonary Venous Anomalies. CONGENIT HEART DIS 2022. [DOI: 10.1016/b978-1-56053-368-9.00007-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lastinger A, El Yaman M, Gustafson R, Yossuck P. Scimitar Syndrome and H-type Tracheo-esophageal Fistula in a Newborn Infant. Pediatr Neonatol 2016; 57:236-9. [PMID: 24269859 DOI: 10.1016/j.pedneo.2013.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 06/27/2013] [Indexed: 01/06/2023] Open
Abstract
Scimitar syndrome is a rare congenital anomaly characterized by partial anomalous pulmonary venous drainage of the right lung to the inferior vena cava (IVC) creating a tubular opacity paralleling the right cardiac border on chest radiography which resembles a curved Turkish sword or scimitar. Associated pulmonary and vascular anomalies have been reported in cases of Scimitar syndrome, most commonly hypoplasia of right lung, dextroposition of the heart, hypoplasia of the right pulmonary artery, and aberrant arterial supply from the descending aorta to the affected lobe of the right lung. To the best of our knowledge, this is the first case of Scimitar syndrome with an H-type tracheoesophageal fistula that has ever been reported.
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Affiliation(s)
- Allison Lastinger
- Department of Pediatrics-Internal Medicine, WVU School of Medicine, Morgantown, WV 26505, USA
| | - Malek El Yaman
- Department of Pediatrics, WVU School of Medicine, Morgantown, WV 26505, USA
| | - Robert Gustafson
- Department of Pediatric Cardiovascular and Thoracic Surgery, WVU School of Medicine, Morgantown, WV 26505, USA
| | - Panitan Yossuck
- Department of Pediatrics-Internal Medicine, WVU School of Medicine, Morgantown, WV 26505, USA.
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Bando Y, Nakagawa M, Ito K, Ozawa Y, Sakurai K, Shimohira M, Shibamoto Y. Horseshoe Lung Associated with Left Lung Hypoplasia: Case Report and Systematic Review of the Literature. Pol J Radiol 2015; 80:464-9. [PMID: 26516390 PMCID: PMC4603592 DOI: 10.12659/pjr.894445] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 07/07/2015] [Indexed: 11/21/2022] Open
Abstract
Horseshoe lung (HL) is often associated with cardiovascular malformations such as scimitar syndrome and unilateral lung hypoplasia. In patients with HL, the hypoplastic lung is almost always located on the right side. Cases of HL with a hypoplastic left lung are extremely rare. In this paper, we describe a case of a one-day-old boy with HL involving left lung hypoplasia and perform a systematic review of the literature on HL with left lung hypoplasia. Only 10 cases of HL involving left lung hypoplasia have been reported in the literature. Most of those cases also exhibited cardiovascular malformations and pulmonary hypertension. There have not been any reported cases of HL involving left lung hypoplasia associated with scimitar syndrome. HL involving left lung hypoplasia is rare and tends to be associated with pulmonary hypertension.
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Affiliation(s)
- Yuya Bando
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Motoo Nakagawa
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Koichi Ito
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yoshiyuki Ozawa
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Keita Sakurai
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Masashi Shimohira
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yuta Shibamoto
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Parappil H, Masud F, Salama H, ur Rahman S. Scimitar syndrome with absent right pulmonary artery and severe pulmonary hypertension treated with coil occlusion of aortopulmonary collaterals in a term neonate. BMJ Case Rep 2015; 2015:bcr-2014-208743. [PMID: 25716044 DOI: 10.1136/bcr-2014-208743] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Scimitar syndrome (SS) is a rare congenital malformation with an estimated incidence of approximately 2 in 100 000 births. A wide clinical spectrum is observed in children with this syndrome. The common clinical presentation in infancy is respiratory distress and tachypnoea due to associated pulmonary hypoplasia, pulmonary overcirculation and/or pulmonary hypertension. Babies with SS presenting with cardiac failure are prone to develop exaggerated pulmonary vascular disease. Hence early intervention, using either coil embolisation or surgical intervention, is indicated. We are reporting a case of a term baby boy who presented with respiratory failure during the first 24 h of life. Echocardiogram and CT angiogram revealed SS. The baby needed intubation due to respiratory failure. Aortopulmonary collaterals, identified on aortic angiogram, were successfully occluded with detachable coils.
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Affiliation(s)
- Hussain Parappil
- Department of Neonatology, Hamad Medical Corporation, Doha, Qatar Department of Pediatrics, Weill Cornell Medical College, Doha, Qatar
| | - Faraz Masud
- Department of Pediatric Cardiology, Hamad Medical Corporation, Doha, Qatar
| | - Husam Salama
- Department of Neonatology, Hamad Medical Corporation, Doha, Qatar Department of Pediatrics, Weill Cornell Medical College, Doha, Qatar
| | - Sajjad ur Rahman
- Department of Neonatology, Hamad Medical Corporation, Doha, Qatar Department of Pediatrics, Weill Cornell Medical College, Doha, Qatar
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Abstract
Congenital venolobular or scimitar syndrome is a rare congenital cardiopulmonary anomaly consisting in a partial anomalous pulmonary venous drainage, lung hypoplasia, and anomalous systemic arterial supply to the lung. It can associate with other congenital disorders which will confer the clinical presentation and prognosis of these patients. In most of the cases, the therapeutic approach is partial, as anatomy allows only aberrant arterial embolisation. We present a 6-year-old girl with recurrent pulmonary infections, diagnosed as scimitar syndrome with double collector drainage to the inferior caval vein and left atrium, undergoing interventional catheterisation for complete correction of her disorder. The anomalous systemic artery supply was embolised and the anomalous venous drainage was occluded. The patient was asymptomatic during follow-up, which supports the interventional catheterisation approach as a valid therapeutic option in cases of scimitar syndrome with double venous drainage.
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Midyat L, Demir E, Aşkin M, Gülen F, Ulger Z, Tanaç R, Bayraktaroğlu S. Eponym. Scimitar syndrome. Eur J Pediatr 2010; 169:1171-7. [PMID: 20225123 DOI: 10.1007/s00431-010-1152-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2009] [Accepted: 01/20/2010] [Indexed: 12/31/2022]
Abstract
Scimitar syndrome is a rare congenital anomaly, characterized by partial or complete anomalous pulmonary venous drainage of the right or left lung into the inferior vena cava. The syndrome is commonly associated with hypoplasia of the right lung, pulmonary sequestration, persisting left superior vena cava, and dextroposition of the heart. The pathogenesis of the syndrome is unclear, but it seems to originate from a basic developmental disorder of the entire lung bud early in embryogenesis. Two main forms of scimitar syndrome have been described. Signs and symptoms can start during infancy (infantile form) or beyond (childhood/adult form). The infantile form generally presents within the first 2 months of life with tachypnea, recurrent pneumonia, failure to thrive, and signs of heart failure. The diagnosis of scimitar syndrome is usually made based on the characteristic chest X-ray films and can be confirmed by angiography; however, it is now done mostly by transthoracic or transesophageal echocardiography, noninvasive computed tomography, or magnetic resonance angiography. Fetal echocardiography using three-dimensional power Doppler imaging permits prenatal diagnosis. Most frequently, patients are asymptomatic in the absence of associated abnormalities and can be followed conservatively. For patients with congestive heart failure, repeated pneumonia, or pulmonary-to-systemic blood flow ratios greater than 1.5 and pulmonary hypertension, it is important to reroute the anomalous right pulmonary veins and repair the associated cardiac defects in order to avoid progression to right ventricular failure. The triad of respiratory distress, right lung hypoplasia, and dextroposition of the heart should alert the clinician to think of scimitar syndrome.
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Affiliation(s)
- Levent Midyat
- Division of Pulmonology-Allergy, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey.
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Bratincsák A, Rao RP, El-Said HG. Unusual Variant of a Rare Constellation: A Left-sided Scimitar Syndrome with Connection to the Azygos Vein. CONGENIT HEART DIS 2010; 5:174-7. [DOI: 10.1111/j.1747-0803.2010.00401.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Akay HO, Kervancioglu M, Nazaroglu H, Katar S, Ozmen CA, Kilinc I, Senturk S. Horseshoe lung associated with rare bilateral variant of scimitar syndrome: demonstration by 64-slice MDCT angiography. Pediatr Radiol 2008; 38:563-6. [PMID: 18189131 DOI: 10.1007/s00247-007-0722-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2007] [Revised: 11/07/2007] [Accepted: 11/27/2007] [Indexed: 11/30/2022]
Abstract
Scimitar syndrome with bilateral abnormal venous drainage and horseshoe lung is extremely rare. These rare complex anomalies were diagnosed in a 5-year-old boy by 64-slice multidetector CT (MDCT). This technique provides high-quality visualization of vascular, bronchial and parenchymal structures in a single session, such that no further invasive techniques are required. One obvious disadvantage of MDCT is the radiation exposure, especially in paediatric patients. The use of a single phase of contrast material administration reduces radiation exposure. The workstation platforms of MDCT systems allow multiplanar 2-D and 3-D postprocessing. As a result, various complex pathologies, such as that discussed here, can be diagnosed following a single imaging session with a certain precision.
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Lee ML, Lue HC, Chiu IS, Chiu HY, Tsao LY, Cheng CY, Yang AD. A systematic classification of the congenital bronchopulmonary vascular malformations: dysmorphogeneses of the primitive foregut system and the primitive aortic arch system. Yonsei Med J 2008; 49:90-102. [PMID: 18306475 PMCID: PMC2615272 DOI: 10.3349/ymj.2008.49.1.90] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PURPOSE We reviewed the cases of 33 patients from our clinic and 142 patients from the literature with congenital bronchopulmonary vascular malformations (BPVM), systematically analyzed the bronchopulmonary airways, pulmonary arterial supplies, and pulmonary venous drainages, and classified these patients by pulmonary malinosculation (PM). MATERIALS AND METHODS From January 1990 to January 2007, a total of 33 patients (17 men or boys and 16 women or girls), aged 1 day to 24 years (median, 2.5 months), with congenital BPVM were included in this study. Profiles of clinical manifestations, chest radiographs, echocardiographs, esophagographs, computer tomography (CT), magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), cardiac catheterizations with angiography, contrast bronchographs, bronchoscopies, chromosomal studies, surgeries, and autopsies of these patients were analyzed to confirm the diagnosis of congenital BPVM. A total of 142 cases from the literature were also reviewed and classified similarly. RESULTS The malformations of our 33 patients can be classified as type A isolated bronchial PM in 13 patients, type B isolated arterial PM in three, type C isolated venous PM in two, type D mixed bronchoarterial PM in five, type F mixed arteriovenous PM in one, and type G mixed bronchoarteriovenous PM in nine. CONCLUSION Dysmorphogeneses of the primitive foregut system and the primitive aortic arch system may lead to haphazard malinosculations of the airways, arteries, and veins of the lung. A systematic classification of patients with congenital BPVM is clinically feasible by assessing the three basic bronchovascular systems of the lung independently.
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Affiliation(s)
- Meng-Luen Lee
- Department of Pediatrics, Division of Pediatric Cardiology, Changhua Christian Hospital, No. 135, Nanhsiao St., Changhua 50050, Taiwan.
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Lachman RS. S. TAYBI AND LACHMAN'S RADIOLOGY OF SYNDROMES, METABOLIC DISORDERS AND SKELETAL DYSPLASIAS 2007. [PMCID: PMC7315357 DOI: 10.1016/b978-0-323-01931-6.50027-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Newman B. Congenital bronchopulmonary foregut malformations: concepts and controversies. Pediatr Radiol 2006; 36:773-91. [PMID: 16552585 DOI: 10.1007/s00247-006-0115-4] [Citation(s) in RCA: 103] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2005] [Revised: 12/13/2005] [Accepted: 12/21/2005] [Indexed: 01/11/2023]
Abstract
This article addresses the scope, etiology, important associations and imaging features of congenital bronchopulmonary foregut malformations. Etiologic concepts, including airway obstruction and vascular anomalies, are highlighted. Technical imaging advances, especially CT and MR, have greatly enhanced our diagnostic abilities in evaluating these lesions; however, thorough and careful assessment of all aspects of the malformation is still necessary. Several specific lesions are discussed in more detail, particularly regarding controversial issues in classification, understanding, imaging and management.
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Affiliation(s)
- Beverley Newman
- University of Pittsburgh School of Medicine and Children's Hospital of Pittsburgh, 3705 Fifth Ave, Pittsburgh, PA 15213, USA.
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Freedom RM, Yoo SJ, Goo HW, Mikailian H, Anderson RH. The bronchopulmonary foregut malformation complex. Cardiol Young 2006; 16:229-51. [PMID: 16725062 DOI: 10.1017/s104795110600031x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/05/2005] [Indexed: 12/24/2022]
Affiliation(s)
- Robert M Freedom
- Department of Paediatrics, Division of Cardiology, The University of Toronto, Toronto, Canada
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Abstract
Congenital lung abnormalities include a wide spectrum of conditions and are an important cause of morbidity and mortality in infants and children. This article discusses focal lung abnormalities and the dysmorphic lung. Pulmonary arteriovenous malformations have been included at the end of the article. Anomalies affecting the pulmonary parenchyma, its arterial supply, and venous drainage are thus discussed.
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Affiliation(s)
- Anne Paterson
- Radiology Department, Royal Belfast Hospital for Sick Children, 180 Falls Road, Belfast BT12 6BE, UK.
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Abstract
Scimitar syndrome is a rare congenital anomaly that affects classically the right lung and the heart. We present a rare variant that involves both lungs in association with totally anomalous pulmonary venous connection, horseshoe lung, and right pulmonary cyst.
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Affiliation(s)
- Mohamed Kabbani
- Cardiac Sciences Department, King Abdul Aziz Medical City, Riyadh, Saudi Arabia.
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Berrocal T, Madrid C, Novo S, Gutiérrez J, Arjonilla A, Gómez-León N. Congenital anomalies of the tracheobronchial tree, lung, and mediastinum: embryology, radiology, and pathology. Radiographics 2003; 24:e17. [PMID: 14610245 DOI: 10.1148/rg.e17] [Citation(s) in RCA: 213] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Congenital anomalies of the chest are an important cause of morbidity in infants, children, and even adults. The evaluation of affected patients frequently requires multiple imaging modalities to diagnose the anomaly and plan surgical correction. The authors analyze and illustrate practical aspects of certain common and uncommon congenital anomalies affecting the tracheobronchial tree, lung, and mediastinum, with emphasis on radiologic manifestations. Other thoracic anomalies such as rib anomalies and vascular rings are discussed when they are associated with anomalies of the tracheobronchial tree. The usefulness of the various imaging modalities in the diagnosis and treatment of these conditions is also evaluated. Specific topics addressed include tracheal conditions such as tracheal stenosis, tracheomalacia, tracheal bronchus, tracheal atresia, and bronchogenic cyst; anomalies of the lung such as lung underdevelopment (agenesis and hypoplasia), scimitar syndrome, congenital cystic adenomatoid malformation, congenital lobar emphysema, and pulmonary sequestration; esophageal anomalies such as esophageal atresia, tracheoesophageal fistula, and esophageal duplications; and vascular rings. The embryologic and pathologic basis of the radiologic findings are discussed in appropriate cases. Differential diagnoses, as well as pitfalls and diagnostic difficulties, are included.
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Affiliation(s)
- Teresa Berrocal
- Department of Pediatric Radiology, Hospital Infantil La Paz, 261 Paseo de la Castellana, 28046 Madrid, Spain.
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Abstract
Scimitar syndrome is a rare association of congenital cardiopulmonary anomalies consisting of a partial anomalous pulmonary venous connection of the right lung to the inferior vena cava, right lung hypoplasia, dextroposition of the heart, and anomalous systemic arterial supply to the right lung. To date, this syndrome has not been reported or discussed in the nursing literature. In this article, 5 patients are presented to illustrate the variable presentation of this syndrome, ranging from infants who are asymptomatic to those with heart failure and severe pulmonary hypertension. The clinical signs and symptoms, diagnostic dilemmas, and medical and surgical management are discussed. The triad of respiratory distress, right lung hypoplasia, and dextroposition of the heart should alert the clinician to the possibility of this syndrome.
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Affiliation(s)
- Barbara C Mordue
- Department of Advanced Practice Nursing, Loma Linda University Children's Hospital, Loma Linda, CA, USA.
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Kamijoh M, Itoh M, Kijimoto C, Nagakura T, Okabe T. Horseshoe lung with bilateral vascular anomalies: a rare variant of hypogenetic lung syndrome (scimitar syndrome). Pediatr Int 2002; 44:443-5. [PMID: 12139574 DOI: 10.1046/j.1442-200x.2002.01566.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Makoto Kamijoh
- Department of Pediatrics, Kanagawa Prefectural Atsugi Hospital, Kanagawa, Japan.
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