The mediobasal segment (S7) of the right lung has been considered to correspond to the cardiac lobe generally seen in mammals. To investigate fetal development of the right mediobasal segmental bronchus (B7), we examined paraffin-embedded serial sections of 15 embrynic and fetal lungs at 7-8 weeks (serial sections) as well as semiserial sections of 8 fetuses at 15-18 weeks (semiserial sections). All of the smaller specimens did not contain B7, but 2 of the 8 larger specimens carried B7: one was found in the immediately anterior side of the inferior pulmonary vein, while in the other, the subdivisions (B7a, B7b) were overriding the vein. Although the incidence might be underestimated because of observations using semiserial sections, the B7 was most likely to develop secondarily during a period from 8 to 15 weeks. Fetal topographical changes (mainly, the descent) of the middle lobe and the inferior pulmonary vein might relate with the secondarily budding of B7. The present result does not reduce a clinical relevance of B7 as a segmental bronchus of the lung segment system.
Bronchi ; Fetal Development* ; Fetus ; Incidence ; Lung* ; Mammals ; Pulmonary Veins ; Veins

Pulmonary venous stenosis may be congenital or acquired. Regardless of its origin, the prognosis for patients affected with PVS remains poor. There have been many attempts to palliate PVS with little success. This report describes two patients with PVS which became evident after repair of total anomalous pulmonary venous connection. Intravascular stents were successfully implanted, but progressive restenoses in the stents occurred and eventually both of the patients died. The pertinent literature is reviewed.
Constriction, Pathologic* ; Humans ; Prognosis ; Pulmonary Veins ; Stents*

The remaining lung infarction is a rare but life-threatening complication after a thoracic operation and trauma. We report a case of this rare complication after the left upper lobectomy due to pulmonary aspergilloma. The infarction of the remaining left lower lobe occurred due to kinking of the pulmonary vessels after the left upper lobectomy and the completion pneumonectomy was performed in the post-operative second day. Therefore, prompt diagnosis and treatment may be necessary to prevent morbidity and mortality associated with pulmonary infarction from torsion of pulmonary artery and vein.
Diagnosis ; Infarction ; Lung ; Mortality ; Pneumonectomy ; Pulmonary Artery ; Pulmonary Infarction* ; Veins

BACKGROUND: Preoperative identification of systemic and pulmonary venous return is essential for surgical design in situs ambiguus. This study was carried out to evaluate anatomy of systemic and pulmonary venous return and to assess clinical efficacy of magnetic resonance imagine(MR) by comparing with results of cardiac catheterization(Cath) and echocardiography(Echo). MATERIALS AND METHODS: MR performed on 22 patients with cardiac situs ambiguus(right isomerism ; 13, left isomerism ; 9). MR findings were compared with the findings of Cath and Echo for the assessment of diagnostic accuracy of MR in 19 patients. RESULTS: 1) Interruptions of IVC with azygous continuation were found in all patients of left isomerism. But IVC was drained to right of left sided atria in right isomerism. 2) Brlateral SVC were found in 12 of 22 situs ambiguus(left isomersm ; 5, right isomerism ; 8). 3) Total anomalous pulmonary venous returns(TAPVR) were found in 7 of 12 right isomerism. Location of vertical veins were as follows ; prearterial(n=1), retroarterial-prebronchial(n=3), retrobronchial(n=3). In 5 patients of remained 6 right isomerism, pulmonary venous returns(PAPVR) in which right and left pulmonary veins entered to right and left atrium respectively, were found in 5 of 9 left isomerism. 4) Compared with Cath and Echo findings(n=19) in which MR, Cath and Echo were performed simultaneously, TAPVR were found in 6 cases on MR but 2 cases on Cath and Echo. The cases that were not detected by Cath showed severe decrement of pulmonary flow due to hypoplasia of pulmonary artery or obstruction of pulmonary vein. On MR, accurate anatomy of PAPVR were found only in 4 cases. CONCLUSIONS: MR can provide accurate and complete imaging of systemic and pulmonary venous return in sitrs ambiguus. Especially, MR is superior to Cath or Echo in depiction of TAPVR with severe decrement of pulmonary flow of obstruction of pulmonary vein, PAPVR and bilateral SVC.
Heart ; Heart Atria ; Heterotaxy Syndrome* ; Humans ; Isomerism ; Pulmonary Artery ; Pulmonary Veins ; Scimitar Syndrome ; Veins

To investigate the value of echocardiography in the diagnosis of total anomalous pulmonary venous connection (TAPVC), 16 patients in our hospital were diagnosed to have TAPVC by echocardiography from year 1994 to 2001. In 11 cases the results of echocardiography were compared to those of surgery. Each patient was examined by using a combination of precordial, suprasternal and subcostal windows to visualize all the pulmonary veins and their drainage sites, common pulmonary venous trunk, and other associated abnormalities. Of the 16 cases, the drainage sites were as follow: supracardiac in 10, via vertical vein in 9, directly to superior vena cava in 1; cardiac in 5, via coronary sinus in 2, directly to right atrium in 3. Diagnoses were correctly made in all the 11 cases as confirmed by surgery. Echocardiography can also assess pulmonary arterial pressure and detect other associated abnormalities. It is concluded that echocardiography is the preferred examination method in the diagnosis of TAPVC before surgery. With careful examination using multiple windows and sections, TAPVC can be accurately diagnosed by echocardiography.
*Echocardiography, Doppler, Color ; Heart Defects, Congenital/*ultrasonography ; Pulmonary Veins/*abnormalities ; Pulmonary Veins/ultrasonography

BACKGROUND: Pulmonary vessel sarcomas are rare, and their pathogenesis is still unclear. METHODS: We focus on the pathologic findings of fourteen pulmonary artery and/or vein sarcomas along with clinical prognosis. RESULTS: Nine patients were male and five were female, and they ranged in age from 26 to 72 years (mean, 47 years). There were ten cases of pulmonary artery sarcoma, three cases of pulmonary artery and vein sarcoma, and one case of pure pulmonary vein sarcoma. Ten out of the fourteen cases were associated with pulmonary thromboembolism. Microscopically, all the tumors showed an undifferentiated sarcomatous portion. There were leiomyosarcoma portions in 8 cases, malignant fibrous histiocytomatous portions in 7 cases, angiosarcomatous differentiation in 3 cases, and osteosarcomatous portion in 1 case. All but two patients died during the follow up period (range, 1 to 78 months). The mean survival time of the patients who died was 14 months and the longest survival time was 78 months after surgical resection. CONCLUSIONS: The current study is one of the largest single institutional reviews of pulmonary artery and/or vein sarcoma. Regardless of the histological components and macroscopic growth patterns, these rare tumors have a grave prognosis.
Female ; Follow-Up Studies ; Glycosaminoglycans ; Humans ; Leiomyosarcoma ; Male ; Prognosis ; Pulmonary Artery ; Pulmonary Embolism ; Pulmonary Veins ; Sarcoma ; Survival Rate ; Veins

The surgical management of patients whose pulmonary arteries are discontinuous from the ventricular mass depends in part on adequate visualization and quantification of the pulmonary arteries. Pulmonary vein wedge angiography has proven effective technique in demonstrating the true mediastinal(intrapericardial) pulmonary arteries(when present) when standard anterograde injections do not suffice. Pulmonary vein wedge angiography was performed in 11 patients during cardiac catheterization at Serverance Hospital Yonsei University College of Medicine between June, 1984 and December, 1985. In all the patients, venous angiography gave a more complete, clear picture of the pulmonary arteries. We feel that pulmonary venous wedge angiography often is superior to and at least complements standard angiographic methods of opacifying the pulmonary artries in patients with pulmonary atresia or occluded pulmonary arteries. We recommend it as a routine part of the evaluation of these patients.
Angiography* ; Cardiac Catheterization ; Cardiac Catheters ; Complement System Proteins ; Humans ; Pulmonary Artery* ; Pulmonary Atresia* ; Pulmonary Veins*

A statistical comparison of pulmonary artery and pulmonary venous wedge pressure has been made by the correlation coefficient method in 24 children with various congenital heart disease. None of them had pulmonary hypertension above the normal range. During the systolic phase, pulmonary arterial pressure was 2.02+/-2.64mmHg greater than pulmonary venous wedge pressure with poor correlation(r=0.57). During the diastolic phase, pulmonary venous wedge pressure was 2.08+/-2.47mmHg greater than pulmonary aetery pressure with poor correlation(r=-.63). Mean pulmonary arterial pressure was 0.79+/-1.02mmHg greater than pulmonary venous wedge pressure with good correlation (r=0.96). Therefore, it is concluded that if pulmonary artery is not entered, a pulmonary vein wedge pressure is a useful indication of pulmonary artery mean pressure in selected cases of congenital heart disease.
Arterial Pressure ; Child ; Heart Defects, Congenital* ; Humans ; Hypertension, Pulmonary ; Pulmonary Artery* ; Pulmonary Veins ; Pulmonary Wedge Pressure* ; Reference Values

BACKGROUND: Sometimes adequate pulmonary venous flow signal could not be obtained in transthoracic echocardiogram. It has been reported that contrast agent that has transpulmonary passage capability could be used in the enhancement of Doppler signal in the left side of the heart. We evaluated the Levovist(R)-enhanced pulmonary vein flow signals obtained by transthoracic echocardiogram and compared with those obtained by transesophageal echocardiogram. METHOD: Ten patients(male 8, female 10, mean age 46+/-11) with sinus rhythm who underwent transesophageal echocardiogram were enrolled. Spectral Doppler signal intensity(score; 0-5), systolic time velocity integral(Stvi), diastolic time velocity integral(Dtvi) of pulmonary vein flow before and after intravenous injection of the contrast were obtained and compared with those obtained by transesophageal echocardiogram. RESULTS: There was no serious side effect related to Levovist(R). Spectral Doppler signal intensity score of pulmonary vein flow with nonenhanced transthoracic echocardiogram was 2.1 / 5, and adequate Doppler signal could not be obtained in two patients. After contrast enhancement, Doppler signal intensity score rose up to 4.3 / 5 and adequate Doppler signal could be obtained in all patients. Time velocity integrals of systolic and diastolic pulmonary vein flow obtained by transthoracic echocardiogram correlated well with those obtained by transesophageal echocardiogram. CONCLUSION: Contrast enhancement of Doppler signal with the agent that has transpulmonary passage capability(Levovist(R)) is useful in the evaluation of pulmonary vein flow in patient whose transthoracic echocardiographic Doppler signal is inadequate.
Echocardiography ; Female ; Heart ; Humans ; Injections, Intravenous ; Pulmonary Veins*

PURPOSE: Doppler findings of pulmonary venous flow in large atrial septal defect(ASD) has been known to show a contiguous form rather than showing a form with two peaks in a cardiac cycle. The aim of this study was to find out the affecting variables in flow pattern change. METHODS: The present study was conducted on 16 isolated secondum ASD infants with defect diameters greater than 3 mm(L group), 10 infants with a defect diameter less than 3 mm(S group) and 11 infants with no structural abnormal findings(N group), among infants who visited the Pediatric Department of Soonchunhyang University Hospital and underwent a echocardiographic examination from April 2001 through June 2003. The echocardiographic examination included the midflow ratio of the pulmonary vein, calculated by division(numerator:the minimum velocity between S & D velocities, denominator: the mean value of S & D velocities). RESULTS: The mean ages of these three groups(L group, S group and N group) were 0.35+/-0.34 years, 0.22+/-0.22 years and 0.45+/-0.27 years, respectively. The midflow ratios were 0.76+/-0.20, 0.54 +/-0.11, 0.53+/-0.11 in groups, and significant difference between L group and the other two groups (P=0.002). The only affecting variable to midflow ratio is the defect area. And there is a significant causal relationship between them(P=0.003). CONCLUSION: The fact that Doppler findings of the pulmonary venous flow in a large sized atrial septal defect show a contiguous form is thought to be due to the unique hemodynamic characteristics of the ASD. The results of this study showed that such altered pattern ascertained as the defect size became larger.
Echocardiography ; Heart Septal Defects, Atrial* ; Hemodynamics ; Humans ; Infant* ; Pulmonary Veins