title: Concurrent aortic valvular disease and pulmonary sequestration: clinical implications.
abstract: Pulmonary sequestration refers to segmental lung tissue that has no connection with the bronchial tree or pulmonary arteries. In adults, the clinical sequelae are usually related to infection. Patients are typically referred for sequestrectomy even when they are asymptomatic. There are no guidelines for treating patients who have pulmonary sequestration and coexisting cardiac valvular disease, in which case the venous drainage patterns of sequestra pose the additional risks of infective endocarditis and volume overload. We present the cases of 2 adult patients--one symptomatic and one asymptomatic--who had concurrent aortic valvular disease and pulmonary sequestration, and we discuss the factors involved in our evaluation of their cardiac risk and our treatment decisions. In view of the sparse data to predict cardiac risks, we think that pulmonary sequestrectomy in adult patients with concurrent valvular conditions should be considered on a case-by-case basis.
authors.forename: Dawn S
authors.initials: DS
authors.lastname: Hui
authors.forename: David M
authors.initials: DM
authors.lastname: Shavelle
authors.forename: Vaughn A
authors.initials: VA
authors.lastname: Starnes
authors.forename: P Michael
authors.initials: PM
authors.lastname: McFadden
mesh_terms: D001021:Aortic Valve / Q000002:abnormalities* / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D000082882:Bicuspid Aortic Valve Disease; D001998:Bronchopulmonary Sequestration / Q000150:complications* / Q000175:diagnosis; D006349:Heart Valve Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Abnormalities, multiple/diagnosis; bronchopulmonary sequestration/complications/diagnosis/surgery; endocarditis, bacterial/complications/etiology/pathology; heart valve diseases/etiology; lung/blood supply; treatment outcome