Correct!
4. Pulmonary agenesis
Interruption of the pulmonary artery (in this case, right-sided, which is the most common form of this rare anomaly), congenital unilateral pulmonary venous atresia, and pulmonary hypoplasia are developmental abnormalities of the thorax which may be associated with volume loss on the affected side of the thorax. Previous surgical resection can also produce unilateral thoracic volume loss. Other conditions that may produce unilateral thoracic volume loss include endobronchial obstruction and visceral pleural restriction due to post-inflammatory pleural thickening or neoplasia. Pulmonary agenesis (and pulmonary aplasia; see July 2017 Case of the Month) is also associated with significant unilateral volume loss, but, unlike the other entities listed, both pulmonary agenesis and aplasia are associated with both severe volume loss and opacity affecting the affected side of the thorax, due to complete shift of the heart, great vessels, and mediastinum into the affected thorax. The other conditions listed above are associated with unilateral volume loss, but because lung is present on the affected side, the affected thorax does not show increased opacity, unlike pulmonary agenesis and pulmonary aplasia.
Which of the following represents the most appropriate next step for the managementof this patient? (Click on the correct answer to proceed to the fourth of nine pages)