Anil Kumar Singhi, Manojit Lodha, Santunu De, Arpita Choraria, Sandip Sardar, Ejaz Ahmed Bari, Debadri Chakrabarti
Manipal Hospital EM Bypass. Vivekananda Institute of Medical Sciences.
India
Journal of Cardiology Cases
J Cardiol Cases 2025 Aug 5; 32: 207-210
DOI: 10.1016/j.jccase.2025.07.007
Abstract
A 26-year-old woman with chronic effort intolerance and a continuous murmur underwent evaluation for suspected congenital heart disease. While initial assessments raised suspicion for a patent ductus arteriosus, computed tomography pulmonary angiography confirmed a rare systemic arterial collateral originating from the left subclavian artery and supplying the left lung. Due to significant left heart chamber dilatation, transcatheter closure was undertaken. A 20-mm vascular plug was successfully deployed to occlude the primary collateral. However, during attempted closure of an additional undetected collateral, sheath migration resulted in vascular dissection and intrapulmonary hemorrhage. The patient required mechanical ventilation, blood transfusion, and intercostal drainage. Hemostasis happened with clot formation at the bleeding site, and the patient gradually stabilized. She was discharged in good clinical condition after seven days. This case underscores the diagnostic and procedural challenges associated with anomalous systemic arterial supply to the lung. It highlights the potential for serious complications despite minimally invasive approaches and emphasizes the critical role of multidisciplinary collaboration in ensuring successful outcomes.
Category
Abnormal Systemic to Pulmonary Arterial Collaterals or Connections Associated with Pulmonary Vascular Disease
Diagnostic Testing for Pulmonary Vascular Disease. Non-invasive Testing
Surgical and Catheter-mediated Interventions for Pulmonary Vascular Disease
Age Focus: Adult Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes