101
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Sánchez Nistal M. Pulmonary hypertension: The contribution of MDCT to the diagnosis of its different types. RADIOLOGIA 2010. [DOI: 10.1016/s2173-5107(10)70024-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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102
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Idiopathic Pulmonary Artery Aneurysm Treated With Surgical Correction and Concomitant Coronary Artery Bypass Grafting. Ann Thorac Surg 2009; 88:273-5. [DOI: 10.1016/j.athoracsur.2008.11.037] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2008] [Revised: 11/05/2008] [Accepted: 11/10/2008] [Indexed: 11/18/2022]
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103
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Akay HO, Ozmen CA, Bayrak AH, Senturk S, Katar S, Nazaroglu H, Taskesen M. Diameters of normal thoracic vascular structures in pediatric patients. Surg Radiol Anat 2009; 31:801-7. [DOI: 10.1007/s00276-009-0525-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2009] [Accepted: 05/27/2009] [Indexed: 11/29/2022]
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104
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Kotwica T, Szumarska J, Staniszewska-Marszalek E, Mazurek W, Kosmala W. Idiopathic Pulmonary Artery Aneurysm. Echocardiography 2009; 26:593-5. [DOI: 10.1111/j.1540-8175.2008.00827.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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105
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Kodikara S, Sivasubramanium M. Bilateral pulmonary artery aneurysms. Leg Med (Tokyo) 2009; 11 Suppl 1:S496-7. [PMID: 19342275 DOI: 10.1016/j.legalmed.2009.02.068] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2009] [Accepted: 02/02/2009] [Indexed: 11/28/2022]
Abstract
Pulmonary artery aneurysms are rare. The estimated incidence is 1 in 14,000 in autopsies. Bilateral main pulmonary artery aneurysms have not been previously reported in the literature. A 36-year-old woman who has been diagnosed as having an ostium secundum defect with severe pulmonary hypertension was found dead. Autopsy revealed an emaciated body. The heart was enlarged. Right atrium and ventricle were dilated. There were bilateral unruptured main pulmonary artery aneurisms. Atheromatous plaques of the pulmonary artery were seen. There was no thrombosis. Histology confirmed the pulmonary artery aneurysm and pulmonary atheroma. The cause of death was concluded as right heart failure due to bilateral main pulmonary artery aneurisms caused by an ostium secundum defect of the heart.
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Affiliation(s)
- Sarathchandra Kodikara
- Department of Forensic Medicine, Faculty of Medicine, University of Peradeniya, 20400, Sri Lanka.
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106
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Fakler U, Mebus S, Kaemmerer H, Will A, Eicken A, Weiss M, Reichard B, Hess J. A ticking time bomb--high pressure pulmonary artery aneurysm. Am J Med 2008; 121:777-80. [PMID: 18724967 DOI: 10.1016/j.amjmed.2008.06.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2007] [Revised: 05/31/2008] [Accepted: 06/02/2008] [Indexed: 11/18/2022]
Affiliation(s)
- Ullrich Fakler
- Klinik für Kinderkardiologie und angeborene Herzfehler, Deutsches Herzzentrum München, Technische Universität München, Germany.
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107
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Multiple Mycotic Aneurysms of the Pulmonary Arteries Resolving With Conservative Management. J Thorac Imaging 2008; 23:197-201. [DOI: 10.1097/rti.0b013e318176b917] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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108
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109
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Ritter C, Weininger M, Machann M, Beissert M, Hahn D, Kenn W. Non-invasive imaging in a rare case of main pulmonary artery aneurysm. Respir Med 2008; 102:790-2. [DOI: 10.1016/j.rmed.2007.10.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2007] [Accepted: 10/16/2007] [Indexed: 11/28/2022]
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110
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Tomashefski JF, Cagle PT, Farver CF, Fraire AE. Pulmonary Vascular Disease. DAIL AND HAMMAR’S PULMONARY PATHOLOGY 2008. [PMCID: PMC7120700 DOI: 10.1007/978-0-387-68792-6_28] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The pulmonary vasculature is an anatomic compartment that is frequently overlooked in the histologic review of lung biopsy samples, other than those obtained specifically to assess pulmonary vascular disease.1 Though often of a nonspecific nature, the histologic pattern of vascular remodeling may at times suggest its underlying pathogenesis and provide clues to the cause of pulmonary hypertension.2 Disproportionately severe vascular pathology may further indicate alternate disease processes, such as congestive heart failure or thromboemboli, contributing to the patient’s overall respiratory condition.
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Affiliation(s)
- Joseph F. Tomashefski
- grid.67105.350000000121643847Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH USA ,grid.411931.f0000000100354528Department of Pathology, MetroHealth Medical Center, Cleveland, OH USA
| | - Philip T. Cagle
- grid.5386.8000000041936877XDepartment of Pathology, Weill Medical College of Cornell University, New York, NY ,grid.63368.380000000404450041Pulmonary Pathology, Department of Pathology, The Methodist Hospital, Houston, TX USA
| | - Carol F. Farver
- grid.239578.20000000106754725Pulmonary Pathology, Department of Anatomic Pathology, The Cleveland Clinic Foundation, Cleveland, OH USA
| | - Armando E. Fraire
- grid.168645.80000000107420364Department of Pathology, University of Massachusetts Medical School, Worcester, MA USA
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111
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112
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Provenzano SC, Jones OD, Miller OI, Grant PW. Idiopathic Pulmonary Trunk Aneurysm Causing Airway Obstruction in an Infant. Heart Lung Circ 2007; 16:454-6. [PMID: 17350891 DOI: 10.1016/j.hlc.2006.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2006] [Revised: 10/05/2006] [Accepted: 10/18/2006] [Indexed: 11/25/2022]
Abstract
We report a case of idiopathic pulmonary trunk aneurysm in an infant, in which the main clinical picture was airway obstruction. Aneurysmorraphy was the chosen surgical approach and showed to be successful on 13 months follow-up.
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113
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Abstract
Pulmonary artery aneurysm is a rare lesion of the thoracic cavity. Different etiologies have been reviewed, but idiopathic lesions without other symptoms are seldom reported. Usually, surgical interventions are suggested, but the long-term outcomes are not well established. Here, we report a 24-year-old man with main pulmonary artery aneurysm who successfully underwent aneurysmectomy and polytetrafluoroethylene vascular graft replacement. The postoperative course was uneventful, and the following image study revealed normal size of the great vessels.
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Affiliation(s)
- Hsin-Hung Shih
- Division of Cardiovascular Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
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114
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Vural AH, Türk T, Ata Y, Göncü T, Ozyazicioglu A. Idiopathic asymptomatic main pulmonary artery aneurysm: surgery or conservative management? A case report. Heart Surg Forum 2007; 10:E273-5. [PMID: 17599873 DOI: 10.1532/hsf98.20061199] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Idiopathic main pulmonary artery aneurysm is a very rare entity and there are no clear guidelines for optimal treatment. Operative treatment is recommended for patients with a risk of rupture, which is not well defined. We present an unusual case of a 53-year-old woman with an idiopathic main pulmonary artery aneurysm. Our case is asymptomatic, without a causative cardiac lesion and/or pulmonary hypertension; therefore, we did not operate on our patient and she was stable at 22-month follow-up.
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Affiliation(s)
- A Hakan Vural
- Cardiovascular Surgery Department, Bursa Yüksek Ihtisas Education and Research Hospital, Bursa, Turkey.
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115
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Saida T, Ninomiya H, Yamasaki M, Yamauchi T. Mycotic pulmonary artery aneurysm as a late complication of infective endocarditis after pacemaker implantation. ACTA ACUST UNITED AC 2007; 25:240-2. [PMID: 17581714 DOI: 10.1007/s11604-007-0124-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2006] [Accepted: 01/25/2007] [Indexed: 11/28/2022]
Abstract
A 49-year-old-woman who had had a pacemaker implanted 15 years earlier became acutely ill with a continuous high fever and general fatigue. A pulmonary artery aneurysm had been rapidly developing and had arrived at the acute phase within 2 weeks. After removal of the pacemaker and with antibiotic therapy the aneurysm gradually decreased in size and has been without rupture for 3 years. Conservative treatment seemed to be sufficient for the management of a mycotic aneurysm in this case.
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Affiliation(s)
- Tsukasa Saida
- Department of Diagnostic Radiology and Interventional Radiology, Tsukuba University Hospital, 2-1-1 Amakubo, Tsukuba, 305-8558, Japan.
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116
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Takao H, Makita K, Doi I, Watanabe T. Mycotic pulmonary artery aneurysm diagnosed 18 years after bacterial endocarditis. Clin Imaging 2007; 31:131-3. [PMID: 17320781 DOI: 10.1016/j.clinimag.2006.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2006] [Accepted: 10/02/2006] [Indexed: 11/20/2022]
Abstract
A 21-year-old woman with a history of bacterial endocarditis and ventricular septum defect repair was referred for evaluation of a mass in the right mid-lung field. A contrast-enhanced computed tomography scan of the chest showed an aneurysm of the right lateral pulmonary artery. The aneurysm was considered to be mycotic in origin. The aneurysm was treated by coil embolization using 19 detachable coils measuring 425 cm in overall length.
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Affiliation(s)
- Hidemasa Takao
- Department of Radiology, Showa General Hospital, Tokyo, Japan.
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117
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Nguyen ET, Silva CIS, Seely JM, Chong S, Lee KS, Müller NL. Pulmonary Artery Aneurysms and Pseudoaneurysms in Adults: Findings at CT and Radiography. AJR Am J Roentgenol 2007; 188:W126-34. [PMID: 17242217 DOI: 10.2214/ajr.05.1652] [Citation(s) in RCA: 112] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this pictorial essay is to illustrate the radiologic manifestations of pulmonary artery aneurysms and pseudoaneurysms with emphasis on the findings on contrast-enhanced CT. CONCLUSION Pulmonary artery aneurysms and pseudoaneurysms are uncommon. Most are caused by trauma, often iatrogenic, infection, and Behçet's syndrome. Less common causes include pulmonary hypertension, congenital heart disease, neoplasms, and connective tissue disease. Recognition of pulmonary artery aneurysms and pseudoaneurysms is important because of the high morbidity and mortality rates of rupture.
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Affiliation(s)
- Elsie T Nguyen
- Department of Radiology, Vancouver General Hospital and The University of British Columbia, 3350-950 W 10th Ave., Vancouver, BC V5Z 4E3, Canada
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118
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Sakuma M, Demachi J, Suzuki J, Nawata J, Takahashi T, Shirato K. Proximal pulmonary artery aneurysms in patients with pulmonary artery hypertension: complicated cases. Intern Med 2007; 46:1789-93. [PMID: 17978536 DOI: 10.2169/internalmedicine.46.0187] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Cases with proximal pulmonary artery aneurysm (PAA) sometimes have severe complications. We report 4 cases of proximal PAA complicated by pulmonary hypertension. Three cases had proximal PAA and one had both proximal and peripheral PAA. Complications associated with proximal PAA are compression of the bronchus, dissection and/or rupture of the pulmonary artery, and thrombus of the pulmonary artery. The available medical treatments have limitations. Two of our patients with proximal PAA are awaiting lung transplantation.
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Affiliation(s)
- Masahito Sakuma
- Division of Internal Medicine, Onagawa Municipal Hospital, Onagawa, Japan.
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119
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Castañer E, Gallardo X, Rimola J, Pallardó Y, Mata JM, Perendreu J, Martin C, Gil D. Congenital and acquired pulmonary artery anomalies in the adult: radiologic overview. Radiographics 2006; 26:349-71. [PMID: 16549603 DOI: 10.1148/rg.262055092] [Citation(s) in RCA: 103] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Various congenital and acquired anomalies may affect the pulmonary arteries in adult patients. Congenital anomalies (proximal interruption, anomalous origin of the left pulmonary artery [pulmonary artery sling], and idiopathic dilatation of the pulmonary trunk) are usually found incidentally at chest radiography or computed tomography (CT). Acquired anomalies include diffuse or focal enlargement of the arteries because of pulmonary hypertension, aneurysm, and intravascular pulmonary metastasis; decreased arterial diameter because of bronchial carcinoma, mediastinal fibrosis, and Takayasu arteritis; and intraluminal filling defects due to pulmonary thromboembolism and pulmonary artery sarcoma. An awareness of the radiologic manifestations of the disease entities and potential pulmonary artery complications secondary to infection or vasculitis may enable an early diagnosis. CT angiography is becoming the standard method for evaluating patients in whom the presence of pulmonary embolism is suspected. CT assessment of the extent of heart effects in patients with pulmonary hypertension and pulmonary embolism is particularly important because such effects largely determine the prognosis.
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Affiliation(s)
- Eva Castañer
- Department of Radiology, SDI UDIAT-CD, Institut Universitari Parc Taulí-UAB, Corporació Parc Taulí, Parc Taulí s/n, Sabadell 08208, Barcelona, Spain.
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120
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Lee CC, Adamson D, Madani M, Manecke GR. Transesophageal Echocardiography and the Intraoperative Diagnosis of a Right Pulmonary Artery Aneurysm. J Cardiothorac Vasc Anesth 2006; 20:562-4. [PMID: 16884989 DOI: 10.1053/j.jvca.2005.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2004] [Indexed: 11/11/2022]
Affiliation(s)
- Christian C Lee
- Department of Anesthesiology and Surgery, UCSD Medical Center, San Diego, CA, USA
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121
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Agarwal R, Kumar V, Gupta D. Pulmonary mucormycosis: two of a kind. Eur J Intern Med 2006; 17:63-5. [PMID: 16378892 DOI: 10.1016/j.ejim.2005.08.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2005] [Revised: 08/21/2005] [Accepted: 08/26/2005] [Indexed: 10/25/2022]
Abstract
Mucormycosis is an uncommon infection caused by fungi of the class Zygomycetes, suborder Mucorales. It occurs predominantly in the immunodeficient host, the most common risk factor being diabetes mellitus. Pulmonary mucormycosis is a disease that is localized in the lungs or mediastinum. It usually presents in a fulminant manner, although a chronic presentation can also occur. We describe two cases of pulmonary mucormycosis in patients with diabetes mellitus, one with an acute and the other with a chronic presentation. A high level of clinical suspicion, combined surgical and medical therapy, and control of patient's underlying immunosuppression are the key to a successful outcome.
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Affiliation(s)
- Ritesh Agarwal
- Department of Pulmonary Medicine and Histopathology, Postgraduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012, India.
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122
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Mody GN, Lau CL, Bhalla S, Picus D, Ritter J, McCardle T, Patterson GA. Mycotic Pulmonary Artery Pseudoaneurysm. J Thorac Imaging 2005; 20:310-2. [PMID: 16282914 DOI: 10.1097/01.rti.0000179473.54500.65] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We report a rare case of a mycotic pulmonary artery pseudoaneurysm that was detected on CT examination. The pulmonary artery pseudoaneurysm appeared as a rapidly growing enhancing mass without a draining vein and with evidence of surrounding acute hemorrhage on CT.
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Affiliation(s)
- Gita N Mody
- Washington University School of Medicine, St. Louis, MO, USA.
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123
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Camara P, Sane M, Diakhate I, Lefebvre N, Ba-Fall K, Millon A, Mbaye PS, Debonne JM, Margery J. [Exercise-induced dyspnea and hilar enlargement]. REVUE DE PNEUMOLOGIE CLINIQUE 2005; 61:329-31. [PMID: 16292161 DOI: 10.1016/s0761-8417(05)84850-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
We report the case of a 46-year-old man with an uneventful history who was hospitalized for suspected pulmonary embolism. The chest x-ray did not reveal any parenchymatous anomaly but disclosed pseudo-tumoral enlargement of the pulmonary arteries. There was no right ventricular overload at cardiac echography and the pulmonary arterial pressure was normal. Helicoidal angioscan demonstrated aneurismal dilatation of the both pulmonary arteries, complicated by a thrombus on the right. Outcome was favorable with anticoagulation. After ruling out acquired aneurysm, the diagnosis retained was idiopathic aneurysm of the pulmonary arteries.
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Affiliation(s)
- P Camara
- Services Médicaux, Hôpital Principal de Dakar, Dakar, Sénégal
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124
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Affiliation(s)
- Aryeh Fischer
- University of Colorado Health Sciences Center, Denver, USA
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125
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Myruski KS, Manecke GR, Kotzur A, Wahrenbrock EA, Jamieson SW. Late recurrence of cardiac sarcoma presenting as giant pulmonary artery aneurysm. J Heart Lung Transplant 2004; 23:1445-6. [PMID: 15607677 DOI: 10.1016/j.healun.2003.09.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2003] [Revised: 09/29/2003] [Accepted: 09/30/2003] [Indexed: 11/15/2022] Open
Abstract
We report the case of a 46-year-old woman who had undergone cardiac transplantation for a malignant, right ventricular sarcoma. Five years later, she experienced pulmonary hypertension and a pulmonary artery aneurysm. Medical management of the pulmonary hypertension being unsuccessful, she underwent surgical exploration of the pulmonary artery aneurysm and bilateral pulmonary endarterectomy. Intra-operative findings revealed pulmonary artery sarcoma and an unresectable pulmonary artery aneurysm.
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Affiliation(s)
- Kimberly S Myruski
- Department of Anesthesiology, University of California at San Diego Medical Center, San Diego, California, USA
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126
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127
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Kim HS, Oh YW, Noh HJ, Lee KY, Kang EY, Lee SY. Mycotic pulmonary artery aneurysm as an unusual complication of thoracic actinomycosis. Korean J Radiol 2004; 5:68-71. [PMID: 15064561 PMCID: PMC2698115 DOI: 10.3348/kjr.2004.5.1.68] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Although pulmonary artery aneurysms are a rare vascular anomaly, they are seen in a wide variety of conditions, such as congenital heart disease, infection, trauma, pulmonary hypertension, cystic medial necrosis and generalized vasculitis. To our knowledge, mycotic aneurysms caused by pulmonary actinomycosis have not been reported in the radiologic literature. Herein, a case of pulmonary actinomycosis complicated by mycotic aneurysm is presented. On CT scans, this case showed focal aneurysmal dilatation of a peripheral pulmonary artery within necrotizing pneumonia of the right lower lobe, which was successfully treated with transcatheter embolization using wire coils.
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Affiliation(s)
- Hyung Soo Kim
- Department of Radiology, Gunpo Hospital, Wonkwang University College of Medicine, Korea
| | - Yu-Whan Oh
- Department of Radiology, Korea University Hospital and Korea University College of Medicine, Korea
| | - Hyung Jun Noh
- Department of Radiology, Korea University Hospital and Korea University College of Medicine, Korea
| | - Ki Yeol Lee
- Department of Radiology, Korea University Hospital and Korea University College of Medicine, Korea
| | - Eun-Young Kang
- Department of Radiology, Korea University Hospital and Korea University College of Medicine, Korea
| | - Sang Yeub Lee
- Department of Internal Medicine, Korea University College of Medicine, Korea
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128
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Decuypere V, Delcroix M, Budts W. Left main coronary artery and right pulmonary vein compression by a large pulmonary artery aneurysm. BRITISH HEART JOURNAL 2004; 90:e21. [PMID: 15020539 PMCID: PMC1768180 DOI: 10.1136/hrt.2003.029694] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Pulmonary artery aneurysms are uncommon and may be associated with significant morbidity and mortality. The unique combination of left main coronary artery and upper right pulmonary vein compression by a large pulmonary artery aneurysm is reported. Furthermore, the aetiology, clinical manifestations, complications, diagnostic approach, and possible therapeutic interventions are briefly discussed.
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Affiliation(s)
- V Decuypere
- Department of Cardiology, University Hospitals, Leuven, Belgium
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129
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Sueyoshi E, Sakamoto I, Ashizawa K, Hayashi K. Pulmonary and lower extremity vascular lesions in a patient with homocystinuria: radiologic findings. AJR Am J Roentgenol 2004; 182:830-1. [PMID: 14976001 DOI: 10.2214/ajr.182.3.1820830] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Eijun Sueyoshi
- Nagasaki University School of Medicine, Nagasaki 852-8501, Japan
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130
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Dransfield MT, Johnson JE. A Mycotic Pulmonary Artery Aneurysm Presenting as an Endobronchial Mass. Chest 2003; 124:1610-2. [PMID: 14555599 DOI: 10.1378/chest.124.4.1610] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
We report the case of a 49-year-old woman who developed an endobronchial mycotic pulmonary artery aneurysm (PAA) as a complication of pneumonia. After presenting with patchy infiltrates, she developed right lung atelectasis. A noncontrast chest CT scan revealed a mass in the right hilum, and bronchoscopy identified an obstructing lesion in the right mainstem bronchus. Unfortunately, biopsy caused massive hemorrhage, and the patient died. An autopsy identified a mycotic PAA that had invaded the right mainstem. The case suggests that a contrasted CT scan should be included in the evaluation of endobronchial masses and that PAA should be included in the differential diagnosis of such lesions.
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131
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de Jonge I, Vahl A, van der Hulst V. Coil Embolization of a Left Pulmonary Artery Pseudoaneurysm After Penetrating Injury. J Endovasc Ther 2003. [DOI: 10.1583/1545-1550(2003)010<0681:ceoalp>2.0.co;2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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132
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de Jonge I, Vahl A, van der Hulst V. Coil embolization of a left pulmonary artery pseudoaneurysm after penetrating injury. J Endovasc Ther 2003; 10:681-3. [PMID: 12932188 DOI: 10.1177/152660280301000342] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To report successful coil embolization of a rare traumatic pulmonary artery pseudoaneurysm. CASE REPORT A 57-year-old man developed a pulmonary artery pseudoaneurysm 14 days after he had been stabbed with a knife in the left lung. The pseudoaneurysm was diagnosed with contrast-enhanced computed tomography and confirmed by pulmonary arteriography. Coils were deployed in the feeding vessels to occlude the defect. CONCLUSIONS Pulmonary artery pseudoaneurysm after penetrating chest injury can be treated by percutaneous catheter embolization, which is less invasive than surgery.
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Affiliation(s)
- Ingeborg de Jonge
- Departments of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
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133
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García Franco CE, Bravo Bravo JL, Zapatero Gaviria J. [Pulmonary artery pseudoaneurysm secondary to coronary catheterization]. Arch Bronconeumol 2003; 39:190-1. [PMID: 12716564 DOI: 10.1016/s0300-2896(03)75358-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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134
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Nollen GJ, van Schijndel KE, Timmermans J, Groenink M, Barentsz JO, van der Wall EE, Stoker J, Mulder BJM. Magnetic resonance imaging of the main pulmonary artery: reliable assessment of dimensions in Marfan patients on a simple axial spin echo image. Int J Cardiovasc Imaging 2003; 19:141-7; discussion 149-50. [PMID: 12749395 DOI: 10.1023/a:1022860919684] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To investigate if a simple axial spin echo (SE) image can be used for reliable assessment of pulmonary artery dimensions in patients with Marfan syndrome. METHODS Fifty Marfan patients (mean age 33 +/- 10 years; 34 men, 16 women) and 15 normal subjects (mean age 28 +/- 4 years; nine men, six women) underwent cardiac magnetic resonance imaging (MRI). Pulmonary artery dimensions were obtained on axial SE images at two different levels: (1) the level of the pulmonary artery root, and (2) the level of the pulmonary artery bifurcation. To evaluate the accuracy of axial plane measurements 10 Marfan patients also underwent contrast-enhanced MR angiography (CE-MRA). RESULTS In the 10 Marfan patients who also underwent CE-MRA, the mean diameter at the pulmonary bifurcation assessed with CE-MRA (31.5 +/- 3.6 mm) was almost equal to mean diameter assessed with axial SE (30.7 +/- 3.6 mm). Agreement of methodology according to Bland and Altman analysis showed a 95% confidence interval ranging from -2.6 to + 4.4 mm for all distances of the pulmonary artery root. In Marfan patients the mean right-left diameter measured on both axial SE images and CE-MRA was approximately 2.5 mm larger than the anterior-right and anterior-left diameters (p < 0.001). CONCLUSIONS Axial SE MRI is a reliable and easy acquisition to measure pulmonary artery dimensions in patients with Marfan syndrome, and could be used for follow-up, especially in patients with severe involvement of the cardiovascular system. Not only the pulmonary artery trunk but also the asymmetric pulmonary root should be measured, although the clinical relevance of the asymmetric root is not yet known.
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Affiliation(s)
- G J Nollen
- Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands
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135
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Abstract
We present a 29-year follow-up in a patient with ectasia of the pulmonary trunk and mild valvular stenosis. There was no progression from the first presentation at the age of 15 months until the actual age of 30 years, the z-value of the diameter of the pulmonary trunk remaining almost constant (z-value 22). This indicates that pulmonary dilatation with normal pressure may be a benign disease.
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Affiliation(s)
- Christof Rose
- Clinic for Pediatric Cardiology, University of Göttingen, Germany.
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136
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Poplausky MR, Rozenblit G, Rundback JH, Crea G, Maddineni S, Leonardo R. Swan-Ganz catheter-induced pulmonary artery pseudoaneurysm formation: three case reports and a review of the literature. Chest 2001; 120:2105-11. [PMID: 11742949 DOI: 10.1378/chest.120.6.2105] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
The use of Swan-Ganz catheters has increased tremendously since they were first introduced in 1970. Their ability to give vital hemodynamic measurements in critically ill patients makes their use invaluable when providing quality medical care. The formation of pulmonary artery (PA) pseudoaneurysm from a Swan-Ganz catheter-induced perforation of the PA is a rare but potentially fatal complication of Swan-Ganz catheter use. Three case presentations and a review of the literature are presented.
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Affiliation(s)
- M R Poplausky
- Department of Radiology, New York Medical College, Westchester Medical Center, Valhalla, NY 10595, USA.
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137
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Meysman M, Demey J, Van Herreweghe R, Noppen M, Osteaux M, Vincken W. Quiz case. Giant aneurysm of the right pulmonary artery. Eur J Radiol 2001; 40:30-2. [PMID: 11673005 DOI: 10.1016/s0720-048x(01)00352-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- M Meysman
- Respiratory Division, Department of Medicine, University Hospital AZ VUB, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
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138
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Abstract
Main pulmonary artery aneurysms with no underlying pathology are very rare, and the role of surgery in this entity is not well defined. We report our experience of one case.
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Affiliation(s)
- K K Nair
- Division of Cardiopulmonary Surgery, Oregon Health Sciences University, Portland, USA
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139
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Hull DA, Shinebourne E, Gerlis L, Nicholson AG, Sheppard MN. Rupture of pulmonary aneurysms in association with long-standing Waterston shunts. Cardiol Young 2001; 11:123-7. [PMID: 11233391 DOI: 10.1017/s1047951100012531] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Anastomosis of the ascending aorta to the right pulmonary artery, the so-called Waterston shunt, was undertaken as a palliative procedure for children with cyanotic congenital heart disease due to obstruction of the pulmonary outflow tract with reduced pulmonary blood flow. We present the clinicopathological correlations in two patients who underwent construction of Waterston shunts as neonates, and subsequently died of ruptured pulmonary aneurysms in adult life. Rupture should, therefore, be recognized as a late complication of this procedure, and be considered in the long-term follow-up of such patients, especially when the shunted lung is hypertensive.
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Affiliation(s)
- D A Hull
- Department of Histopathology, Royal Brompton Hospital, London, UK
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140
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Abstract
We present 2 cases of huge aneurysm of the main pulmonary artery without significant pulmonary artery hypertension or intracardiac shunt. Both patients underwent surgery where resection of the aneurysm and graft replacement, using Hemashield prosthesis (Meadox Medicals, Oakland, NJ), was performed. They are now leading normal lives without any symptoms.
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Affiliation(s)
- K Kuwaki
- Department of Thoracic and Cardiovascular Surgery, Sapporo Medical University School of Medicine, Hokkaido, Japan.
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141
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Abstract
OBJECTIVE Aneurysm formation of the pulmonary trunk is rare and there is controversy about optimal treatment for this disease. The aim of this article is to report four patients with pulmonary trunk aneurysm which were managed by surgical repair. MATERIALS AND METHODS From 1986 to 1997, we performed surgical repair for pulmonary trunk aneurysm in four patients. There was one male and three female patients with a mean age of 63.3 years (range: 54-78 years). Concomitant diseases were cardiac valvular disease in four patients, thoracic aortic dissection in two, atherosclerotic abdominal aortic aneurysm in two, and coronary artery disease in one. All patients were in New York Heart Association functional class III preoperatively. Surgical procedures for the pulmonary trunk aneurysm included Dacron graft replacement in two patients and aneurysmorrhaphy in two. Associated procedures were cardiac valvular operation in three patients with four lesions and right ventricular outflow tract reconstruction (RVOTR) in one. RESULTS There were no operative mortalities and no late deaths with a mean follow-up period of 6.6 years (range: 2.4-10.0 years). One female patient developed recurrent pulmonary trunk aneurysm 9.5 years after aneurysmorrhaphy, and underwent a second operation where Dacron graft replacement of the aneurysm including pulmonary valve replacement was performed successfully. All patients are now leading normal lives. CONCLUSIONS Surgical management should be considered for large aneurysm of the pulmonary trunk regardless of its etiology and underlying disease to prevent possible rupture with fatal result if the patient has an acceptably low operative risk.
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Affiliation(s)
- K Kuwaki
- Departments of Thoracic and Cardiovascular Surgery, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, 060-0061, Sapporo, Japan
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142
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Pereira de Godoy JM, Batigália F. Bilateral pulmonary artery aneurysm associated with bilateral pulmonary thromboembolism, superior vena caval thrombosis, and Chagas' disease--a case report. Angiology 2000; 51:609-14. [PMID: 10917587 DOI: 10.1177/000331970005100711] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The authors report a case of bilateral pulmonary artery aneurysm in a patient with chronic Chagas' disease and compensated congestive heart failure in whom clinical clues suggested pulmonary thromboembolism, and the actual nature of the lesions was discovered at the time of conventional imaging investigations. This case shows the rarity of bilateral pulmonary aneurysm associated with bilateral pulmonary thromboembolism and the importance of an awareness of this condition in the differential diagnosis for lung masses.
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Affiliation(s)
- J M Pereira de Godoy
- Department of Cardiology and Vascular Surgery, São José do Rio Preto University School of Medicine, São Paulo, Brasil.
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143
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Schoof PH, Gittenberger-De Groot AC, De Heer E, Bruijn JA, Hazekamp MG, Huysmans HA. Remodeling of the porcine pulmonary autograft wall in the aortic position. J Thorac Cardiovasc Surg 2000; 120:55-65. [PMID: 10884655 DOI: 10.1067/mtc.2000.106970] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Dilatation and valve regurgitation are disturbing sequelae of the pulmonary root functioning at systemic pressures. We tried to characterize the histologic mode of adaptation of the neoaortic wall. METHODS We compared routine histologic studies, immunohistochemical staining, and computer-assisted morphometric analysis of aortic, pulmonary autograft, and native pulmonary wall specimens from pigs in which, as a newborn, a valveless pulmonary autograft had been implanted in the aorta. RESULTS Histologic examination of the pulmonary autograft revealed a viable, normally revascularized wall without degenerative phenomena. Smooth muscle cells were enlarged and rearranged. The characteristic "pulmonary" medial elastin lamellar structure was retained, which was confirmed by morphometry. Immunohistochemistry of the autograft revealed relatively strong staining of type III collagen and alpha smooth muscle actin, exclusive staining of basic fibroblast growth factor, and no staining of proliferation markers proliferating cell nuclear antigen and Ki67. CONCLUSION The developing pulmonary autograft in the aortic position becomes normally revascularized, lacks major degenerative phenomena, and retains its own typical pulmonary morphologic features. Remodeling is accomplished by increased extracellular matrix deposition with collagen as an important constituent. The marked expression of growth factors in the autograft suggests the persistence of increased metabolic activity.
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Affiliation(s)
- P H Schoof
- Department of Cardiothoracic Surgery, Leiden University Medical Center, The
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144
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Shimamura Y, Yamaki F, Yamamoto H, Kouda T, Tsukagoshi M. Aneurysm in the pulmonary trunk associated with atrial septal defect, a left coronary artery fistula to the pulmonary trunk, and valvular pulmonary stenosis. THE JAPANESE JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY : OFFICIAL PUBLICATION OF THE JAPANESE ASSOCIATION FOR THORACIC SURGERY = NIHON KYOBU GEKA GAKKAI ZASSHI 2000; 48:329-33. [PMID: 10860291 DOI: 10.1007/bf03218151] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
A 78-year-old woman with an aneurysm in the pulmonary trunk associated with an atrial septal defect, left anterior descending coronary artery fistula to the pulmonary trunk and valvular pulmonary stenosis is reported. The aneurysm showed gradual dilatation over 16 years and was successfully treated using aneurysmorrhaphy. Although there has been some controversy regarding the optimum management for a pulmonary artery aneurysm, surgical correction is thought to be essential for aneurysms associated with congenital cardiac anomalies because of the high incidence of rupture.
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Affiliation(s)
- Y Shimamura
- Department of Cardiovascular Surgery, Nagano Central Hospital, Japan
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145
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van Rens MT, Westermann CJ, Postmus PE, Schramel FM. Untreated idiopathic aneurysm of the pulmonary artery; long-term follow-up. Respir Med 2000; 94:404-5. [PMID: 10845442 DOI: 10.1053/rmed.1999.0750] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A 57-year-old man with an idiopathic aneurysm of the left pulmonary artery is presented. The aneurysm was stable over many decades. No such long-term follow-up of an idiopathic pulmonary aneurysm has been described previously. After 39 years there is no evidence of heart failure or pulmonary hypertension. Because corrective surgery has a variable outcome, and prognosis is suggested to be good in the idiopathic form of pulmonary aneurysm, no surgical correction was proposed.
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Affiliation(s)
- M T van Rens
- Department of Pulmonary Diseases, Sint Antonius Hospital, Nieuwegein, The Netherlands
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146
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Nebra puertas A, Puebla macarrón C, Rosell abós M, Virgós señor B, Fernández gómez J, Medrano peña J, De gregorio ariza M. Concordancia entre los hallazgos obtenidos mediante la arteriografía pulmonar, la radiología de tórax, la tomografía computarizada y la broncoscopia en enfermos con hemoptisis graves. Med Intensiva 2000. [DOI: 10.1016/s0210-5691(00)79619-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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147
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Fuentes Pradera M, Otero Candelera R, Ortega Ruiz F, Franco E. Absceso cerebral como primera manifestación de una fístula arteriovenosa pulmonar familiar. Arch Bronconeumol 1999. [DOI: 10.1016/s0300-2896(15)30059-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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148
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149
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Thierrien J, Gerlis LM, Kilner P, Somerville J. Complex pulmonary atresia in an adult: natural history, unusual pathology and mode of death. Cardiol Young 1999; 9:249-56. [PMID: 10386693 DOI: 10.1017/s104795110000490x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A patient with unrepaired complex pulmonary atresia had a normal life, achieving two successful pregnancies, until the age of 44 years. Confluent central pulmonary arteries were supplied by a fistuious communication from the left coronary artery, and from other collateral arteries arising from the underside of the aortic arch. Unusual aneurysms were present. Death at the age of 46 resulted from dissection and rupture of an aneurysmal dilation of the pulmonary trunk.
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Affiliation(s)
- J Thierrien
- Jane Somerville Grown Up Congenital Heart Unit, National Heart and Lung Institute, Imperial College School of Medicine, and the Royal Brompton Hospital, London, UK
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150
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