www.jpeds.com • THE JOURNAL OF PEDIATRICS INSIGHTS AND IMAGES female infant was born at gestational age of 30 weeks by cesarean delivery with a birth weight of 1250 g. Post- A natal echocardiography showed multiple, small mus- cular ventricular septal defects as well as mild tubular aortic coarctation while arterial duct was still patent (patent ductus arteriosus [PDA]). During Doppler evaluation of the celiac trunk to examine hemodynamic relevance of the PDA, we found an additional vessel originating from the abdominal aorta just above the celiac trunk. This artery was feeding a bilat- eral, echogenic mass (Figure 1; available at www.jpeds.com). Time resolved 3-dimensional (3D) magnetic resonance (MR) angiography conﬁrmed bilateral pulmonary sequestration and Figure 3. Angiographic images in anteroposterior projection visualized its vascular supply (Figure 2). Strongly perfused se- after injection of contrast agent into the aberrant feeding vessel questration vessels draining into pulmonary veins created sig- showing the pulmonary sequestration vascularization A, before niﬁcant left-to-left shunt. This led to volume overload of the and B, after interventional coiling therapy. left heart seen as atrial and ventricular dilation in repeated echocardiograms. Cardiac function was preserved, and our provided. The patient was discharged home 9 days after in- patient
The Journal of Pediatrics – Elsevier
Published: Mar 1, 2018
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