Inadvertent Ligation of the Descending Aorta during Removal of a Pulmonary Sequestration

Congenital vascular abnormality often presents with complicated anatomy and physiology that may result in very challenging anesthesia management, particularly for a small child.1,2 Understanding the uniqueness of is critical to optimize care patient unique abnormality.3 Panels A B show computed tomography three-dimensional reconstructed image pulmonary sequestration feeding vessels 1-yr-old boy. However, it was still identify take-off under direct vision surgical field, surgeon inadvertently incorrectly ligated vessels. Due complexity case, team placed an arterial line right radial artery monitor upper extremity perfusion pulse oximeter on left foot lower oxygenation. The successfully identified two vessels, which appeared take off from common vessel (panel C). ligating assumed led instantaneous elevation blood pressure measured loss oximetry signal extremity. promptly communicated removing ligation rendered return foot. Re-exploration allowed ligate correctly. Carefully reviewing images preoperatively applying monitors reflect are paramount surgery anesthesia.The authors declare no competing interests.