Vascular malformations of the thoracic wall

Both intravenous and intra-arterial DSA have widespread applications in the field of cardiovascular diagnosis. The definition of carotid artery stenosis or severe peripheral vascular disease in the patient undergoing coronary artery bypass surgery might dictate the need for simultaneous carotid and coronary artery surgery or demonstrate the best route for insertion of an intra-aortic balloon. DSA also might find further application in the definition of thoracic aortic dissection, thoracic aortic trauma, and coarctation of the thoracic aorta, as well as in showing the adequacy of repair of thoracic coarctation in patients who remain hypertensive postoperatively...

Three cases of compression of the right wall of the trachea by buckling of the innominate artery in childhood are described. A coarctation of the thoracic aorta is associated in two cases, and a left cervical aortic arch in the third one. In one case, a severe tracheomalacia occurs following the surgical repair of the associated coarctation. This lateral indentation of the trachea is suggestive of right aortic arch but the absence of posterior oesophageal indentation excludes the diagnosis. Angiography is helpful and echography is unable to demonstrate the vascular origin of the tracheal compression...

The authors report a case of arteriovenous aneurysm of the chest wall in a 23 year old woman treated by ligation of the vessels and excision. They discuss the obliteration of vessel by embolization or by a surgical approach. They stress the importance of excision to prevent recurrence.

We report a postmature male infant who died at age 2 h of asphyxiating pulmonary hemorrhage. Autopsy found edema, serous ascites, and vascular malformations within myocardium, lung, mediastinal soft tissue, thoracic-wall skeletal muscle, spleen, thyroid and adrenal glands, and pancreas. The pulmonary malformations had arteriovenous features, while those elsewhere were predominantly capillary; many of the latter contained fibrinous thrombi. Circulating nucleated erythrocytes, siderosis of proximal renal tubular epithelium, and intrahepatocytic and intracanalicular cholestasis were present...

Vascularization of the arms has been studied by impedance plethysmography (rheography) in eight children with Poland syndrome, a common malformation characterized by unilateral hand anomaly and ipsilateral aplasia of the inferior head of the pectoralis major muscle. A marked decrease of the velocity of the systolic increase in the arterial volume (Velm) was shown in the affected arms, and the difference between the two arms was significantly higher in the patients than in a control group (P less than 0.02)...