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Ioakeimidis NS, Pepis P, Valasiadis D, Gkountelas G, Mitrousi K, Tossios P. Large main pulmonary artery aneurysm: Case report and brief review of the literature. Radiol Case Rep 2024; 19:319-325. [PMID: 38028315 PMCID: PMC10661587 DOI: 10.1016/j.radcr.2023.10.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 10/11/2023] [Accepted: 10/14/2023] [Indexed: 12/01/2023] Open
Abstract
Pulmonary artery aneurysms are a rare but often fatal clinical entity with an estimated incidence of 1 in 14,000 individuals in postmortem studies. They can be congenital or acquired. No specific guidelines regarding their optimal management, medical or surgical, currently exist and treatment is planned on a case-by-case basis since data regarding their clinical course and prognosis are limited. We present the case of a 77-year-old male patient who presented at the Emergency Department of our hospital with a complaint of exertional dyspnea and dull substernal pain over 1 week. Upon investigation, a main pulmonary artery true aneurysm measuring 61 mm on Computed Tomography was detected. The patient's history was remarkable for heavy smoking, arterial hypertension, dyslipidemia, known ascending aortic aneurysm, moderate COPD, and past tuberculosis. He was admitted to the Cardiology unit and treated as a case of decompensated heart failure with preserved ejection fraction. His symptoms improved with intravenous diuretics. A past chest MRI report, 7 years before his current event, described the main PA aneurysm measuring 51-52 mm. Regarding the main PA aneurysm, the heart team decided to follow a conservative approach with regular follow-up visits based on the patient's comorbidities, functional status, and slow growth rate of the PA aneurysm. Management of pulmonary artery aneurysms requires a heart-team approach in the context of the patient's underlying conditions and symptoms. More data are required in order to guide a treatment plan with an acceptable risk - benefit profile for each patient.
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Affiliation(s)
- Nikolaos S. Ioakeimidis
- Department of Cardiology, General Hospital of Florina “Eleni Th. Dimitriou”, Egnatias 9, Florina 53100, Greece
| | - Panagiotis Pepis
- Department of Cardiothoracic Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, Thessaloniki 54636, Greece
| | - Dimitrios Valasiadis
- Department of Cardiology, General Hospital of Florina “Eleni Th. Dimitriou”, Egnatias 9, Florina 53100, Greece
| | - Georgios Gkountelas
- Department of Radiology, General Hospital of Florina “Eleni Th. Dimitriou”, Egnatias 9, Florina 53100, Greece
| | - Konstantina Mitrousi
- Department of Cardiac Imaging, Diagnostic Center “Ippokrateio - Ygeia Ptolemaidas”, Trapezountos 44, Ptolemaida 50200, Greece
| | - Paschalis Tossios
- Department of Cardiothoracic Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, Thessaloniki 54636, Greece
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Tomasino M, Soriano Colomè T, Sambola Ayala A, Gordon Ramírez B. Acute pulmonary artery dissection in an adult with chronic pulmonary hypertension secondary to congenital heart disease: a case report. Eur Heart J Case Rep 2023; 7:ytad508. [PMID: 37900663 PMCID: PMC10606221 DOI: 10.1093/ehjcr/ytad508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 09/25/2023] [Accepted: 10/09/2023] [Indexed: 10/31/2023]
Abstract
Background D-Transposition of the great arteries (d-TGA) is characterized by the aorta positioned above the right ventricle and the pulmonary artery above the left ventricle. Acute pulmonary artery dissection (PAD) is a rare and often lethal condition. We present a case report of acute PAD in an adult with d-TGA and pulmonary hypertension. Case summary A 49-year-old male with history of d-TGA palliated with an atrial switch (Mustard) operation, pulmonary venous baffle stenosis treated percutaneously, chronic pulmonary hypertension (mixed group 1 and 2), and severe dilatation of pulmonary arteries (pulmonary trunk of 75 mm) presented to the emergency department with chest pain and acute respiratory failure. Blood pressure was 106/78 mmHg, heart rate 93 b.p.m., and oxygen saturation 88% on room air. A computed tomography (CT) scan showed acute right PAD. He was not considered suitable for surgery nor percutaneous procedure. Epoprostenol was initiated to reduce parietal stress, but after initial stabilization, pulmonary venous stent baffle gradient increased and acute pulmonary oedema occurred. Epoprostenol was withdrawn, and furosemide was initiated, with good clinical response. A follow-up CT scan showed dissection morphological stabilization and false lumen thrombosis, and the patient was discharged. Discussion Pulmonary hypertension and previous pulmonary artery dilatation are reported as the main underlying conditions leading to PAD. No previous cases of PAD are described in patients with history of d-TGA and atrial switch procedure. Evidence regarding the best treatment of PAD is lacking, but it seems reasonable to reduce parietal stress using pulmonary vasodilators. Nevertheless, in patients with post-capillary pulmonary hypertension, pulmonary vasodilatation may cause important pulmonary congestion.
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Affiliation(s)
- Marco Tomasino
- Department of Cardiology, Vall d'Hebron University Hospital, Paseo Vall d'Hebron 119, 08035 Barcelona, Spain
| | - Toni Soriano Colomè
- Department of Cardiology, Vall d'Hebron University Hospital, Paseo Vall d'Hebron 119, 08035 Barcelona, Spain
| | - Antonia Sambola Ayala
- Department of Cardiology, Vall d'Hebron University Hospital, Paseo Vall d'Hebron 119, 08035 Barcelona, Spain
| | - Blanca Gordon Ramírez
- Department of Cardiology, Vall d'Hebron University Hospital, Paseo Vall d'Hebron 119, 08035 Barcelona, Spain
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Egbe AC, Miranda WR, Jain CC, Anderson JH, Stephens EH, Andi K, Goda A, Abozied O, Ramachandran D, Crestanello JA, Francois C, Connolly HM. Risk of pulmonary artery dissection in adults with congenital heart disease. Int J Cardiol 2023; 370:186-190. [PMID: 36216090 DOI: 10.1016/j.ijcard.2022.09.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/07/2022] [Accepted: 09/29/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND There are limited data about the risk of pulmonary artery (PA) dissection in adults with congenital heart disease (CHD), and the purpose of this study was to estimate the incidence of PA dissection in this population. METHODS Retrospective cohort study of adults with CHD that underwent cross-sectional imaging (2003-2020). PA aneurysm was defined as main or branch PA diameter > 40 mm or > 30 mm respectively, and severe PA aneurysm was defined as main or branch PA diameter > 50 mm. RESULTS Of 1, 673 patients (41 ± 10 years; male 58%), 493 (24%), 286 (19%), and 306 (20%) had aneurysms of the main, right, and left PA respectively, while 66 (4%) had severe PA aneurysm. During a median follow-up of 8.2 (interquartile range 3.7-10.3) years, there was one PA dissection in a patient with Eisenmenger syndrome, thus the incidence of PA dissection was 14 per 100,000 patient-years. Of 779 females, 163 had one or more pregnancies during follow-up, and 41 (25%) of these patients had known PA aneurysm at the time of conception. There was no PA dissection during pregnancy. Of the 163 patients, 91 (56%) had cross-sectional imaging before and after pregnancy, there was no significant difference in PA dimension before versus after pregnancy (main PA 35 ± 5 versus 36 ± 4 mm, p = 0.6; right PA 21 ± 3 versus 33 ± 4 mm, p = 0.1; and left PA 23 ± 4 versus 22 ± 4 mm, p = 0.4). CONCLUSIONS The risk of PA dissection was extremely low even in patients with severe PA aneurysm, or in patients with PA aneurysm that became pregnant. Collectively, these data suggest a benign natural history for patients without severe pulmonary hypertension and encourage and a conservative approach in managing patients with PA aneurysm.
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Affiliation(s)
- Alexander C Egbe
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA.
| | - William R Miranda
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - C Charles Jain
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Jason H Anderson
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Kartik Andi
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Ahmed Goda
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Omar Abozied
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Dhanya Ramachandran
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Juan A Crestanello
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Heidi M Connolly
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA
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A gray zone in the literature: indications, options, and outcomes for surgical repair of pulmonary artery aneurysms. Cardiol Young 2022; 32:1638-1643. [PMID: 34852872 DOI: 10.1017/s1047951121004807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Pulmonary artery aneurysms are rare. They are characterised by an aneurysmatic dilatation of the pulmonary vascular bed, including the main pulmonary artery or the accompanying pulmonary artery branches. Increases in pulmonary flow and pulmonary artery pressure increase the risk of rupture: when these conditions are detected, surgical intervention is necessary.This study is a retrospective analysis of 33 patients treated in our paediatric cardiac surgery clinic from 2012 to 2020. Aneurysms and pseudoaneurysms in patients who were patched for right ventricular outflow tract reconstruction and corrected with a conduit were excluded from the study. Seventeen (51.5%) of the patients included in the study were female and 16 (48.5%) were male. The patients were aged between 23 and 61 years (mean 30.66 ± 12.72 years). Graft interpositions were performed in 10 patients (30.3%) and pulmonary artery plications were performed in 23 patients (69.7%) to repair aneurysms. There was no significant difference in mortality between the two groups (p > 0.05).Pulmonary artery aneurysm interventions are safe, life-saving treatments that prevent fatal complications such as ruptures, but at present there is no clear guidance regarding surgical timing or treatment strategies. Pulmonary artery interventions should be performed in symptomatic patients with dilations ≥5 cm or asymptomatic patients with dilations ≥8 cm; pulmonary artery pressure, right ventricular systolic pressure, and pulmonary artery aneurysm diameter must be considered when planning surgeries, their timing, and making decisions regarding indications. Experienced surgical teams can achieve satisfactory results using one of the following surgical techniques: reduction pulmonary arterioplasty, plication, or graft replacement.
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Ku LZ, Xiong QF, Xia J, Lv H, Cheng YP, Jing Ma X. Rare Association of Right Ventricular Double Outlet With a Giant Main Pulmonary Artery Aneurysm With Dissection and Coarctation of Aorta With Dysplasia: A Multimodality Imaging Diagnosis and Therapeutic Approach. Circ Cardiovasc Imaging 2022; 15:e013658. [PMID: 35100810 DOI: 10.1161/circimaging.121.013658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Lei Zhi Ku
- Department of Radiology (L.Z.K.), Wuhan Asia Heart Hospital, P.R. China
| | - Qing Feng Xiong
- Department of Echocardiography (J.X., X.J. X.J.M.), Wuhan Asia Heart Hospital, P.R. China
| | - Juan Xia
- Department of Echocardiography (J.X., X.J. X.J.M.), Wuhan Asia Heart Hospital, P.R. China
| | - Hang Lv
- Department of Cardiac Function (H.L.), Wuhan Asia General Hospital, P.R. China
| | - You Ping Cheng
- Department of Pathology (Y.P.C.), Wuhan Asia General Hospital, P.R. China
| | - Xiao Jing Ma
- Department of Echocardiography (J.X., X.J. X.J.M.), Wuhan Asia Heart Hospital, P.R. China
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Egbe AC, Miranda WR, Bonnichsen CR, Jain CC, Crestanello JA, Francois C, Katta RR, Iftikhar M, Goda AY, Andi K, Gandhi S, Connolly HM. Prevalence and risk of progressive aortic aneurysm and dissection in adults with conotruncal anomalies. Eur Heart J Cardiovasc Imaging 2021; 23:1663-1668. [PMID: 34939103 DOI: 10.1093/ehjci/jeab273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 12/09/2021] [Indexed: 11/12/2022] Open
Abstract
AIMS Conotruncal anomalies share common embryogenic defects of the outflow tracts and great arteries, which result in a predisposition to aortic aneurysms. The purpose of this study was to describe the prevalence and risk of progressive aortic aneurysms in adults with conotruncal anomalies. METHODS AND RESULTS Retrospective study of adults with conotruncal anomalies that underwent cross-sectional imaging 2003-20. Aneurysm was defined as aortic root/mid-ascending aorta >2.1 mm/m2/>1.9 mm/m2, progressive aneurysm as increase by >2 mm, and severe aneurysm as dimension >50 mm. Of 2261 patients (38 ± 12 years; male 58%), 1167 (52%) had an aortic aneurysm, and 205 (14%) had a severe aortic aneurysm. Mean annual increase in aortic root/mid-ascending aorta was 0.3 ± 0.1 mm/0.2 ± 0.1 mm. The 3-, 5-, and 7-year cumulative incidence of the progressive aortic aneurysm was 4%, 7%, and 9%, respectively. The rate of aneurysm growth decreased with age, with no significant growth after age 40 years. There was an excellent correlation between aortic indices from cross-sectional imaging and echocardiography. Of 950 females, 184 had ≥1 pregnancy, and 81 (44%) of the 184 patients had aortic aneurysm prior to pregnancy. There was no aortic dissection or progression of the aortic aneurysm during pregnancy. Overall, there was no aortic dissection during 7984 patient-years of follow-up. CONCLUSIONS Aortic aneurysm was common in patients with conotruncal anomalies. However, the risk of progressive aneurysm or dissection was low. Collectively, these data suggest a benign natural history and perhaps a less frequent need for cross-sectional imaging. Further studies are required to determine the optimal timing for surgical intervention in this population.
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Affiliation(s)
- Alexander C Egbe
- Department of Cardiovascular MedicineMayo Clinic, Rochester, 200 First Street SW, MN, 55905, USA
| | - William R Miranda
- Department of Cardiovascular MedicineMayo Clinic, Rochester, 200 First Street SW, MN, 55905, USA
| | - Crystal R Bonnichsen
- Department of Cardiovascular MedicineMayo Clinic, Rochester, 200 First Street SW, MN, 55905, USA
| | - C Charles Jain
- Department of Cardiovascular MedicineMayo Clinic, Rochester, 200 First Street SW, MN, 55905, USA
| | - Juan A Crestanello
- Department of Cardiovascular Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905
| | - Christopher Francois
- Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Renuka R Katta
- Department of Cardiovascular MedicineMayo Clinic, Rochester, 200 First Street SW, MN, 55905, USA
| | - Momina Iftikhar
- Department of Cardiovascular MedicineMayo Clinic, Rochester, 200 First Street SW, MN, 55905, USA
| | - Ahmed Y Goda
- Department of Cardiovascular MedicineMayo Clinic, Rochester, 200 First Street SW, MN, 55905, USA
| | - Kartik Andi
- Department of Cardiovascular MedicineMayo Clinic, Rochester, 200 First Street SW, MN, 55905, USA
| | - Sangeetha Gandhi
- Department of Cardiovascular MedicineMayo Clinic, Rochester, 200 First Street SW, MN, 55905, USA
| | - Heidi M Connolly
- Department of Cardiovascular MedicineMayo Clinic, Rochester, 200 First Street SW, MN, 55905, USA
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7
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Kauhanen SP, Liimatainen T, Korhonen M, Parkkonen J, Vienonen J, Vanninen R, Hedman M. Pulmonary Artery Dilatation Is a Common Finding in a Coronary Artery CT Angiography Population. In Vivo 2021; 35:2177-2185. [PMID: 34182495 DOI: 10.21873/invivo.12489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND/AIM Dilatation of the main pulmonary artery (mPA) is a common incidental finding in chest imaging and often leads to consultation. The aim of this study was to determine the prevalence of mPA dilatation in a coronary artery CT angiography (CCTA) population. PATIENTS AND METHODS The study investigated 985 consecutive patients scheduled for diagnostic CCTA. The transverse axial diameter of the mPA was measured. The prevalence of mPA dilatation was estimated using different reference values (Framingham Heart Study: 28.9 mm for males and 26.9 mm for females, Bozlar: 29.5 mm for both genders and Karazincir: 32.6 mm for males and 31.9 mm for females). RESULTS The patient mean age was 53.0±9.7 years (66.5% were women). Body surface area (BSA) correlated moderately with the mPA diameter (r=0.423, p<0.001). The prevalence of mPA dilatation varied from 5.9% (Karazincir) to 33.7% (Framingham Heart Study) in the overall study population. CONCLUSION The prevalence of mPA dilatation is high in a CCTA patient population when using a cut-off value from the Framingham Heart Study.
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Affiliation(s)
- S Petteri Kauhanen
- School of Medicine, Clinical Radiology, University of Eastern Finland, Kuopio, Finland; .,Department of Clinical Radiology, Kuopio University Hospital, Clinical Imaging Center, Kuopio, Finland
| | - Timo Liimatainen
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.,Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Miika Korhonen
- Department of Clinical Radiology, Kuopio University Hospital, Clinical Imaging Center, Kuopio, Finland
| | - Johannes Parkkonen
- School of Medicine, Clinical Radiology, University of Eastern Finland, Kuopio, Finland
| | - Juska Vienonen
- School of Medicine, Clinical Radiology, University of Eastern Finland, Kuopio, Finland
| | - Ritva Vanninen
- School of Medicine, Clinical Radiology, University of Eastern Finland, Kuopio, Finland.,Department of Clinical Radiology, Kuopio University Hospital, Clinical Imaging Center, Kuopio, Finland
| | - Marja Hedman
- Department of Clinical Radiology, Kuopio University Hospital, Clinical Imaging Center, Kuopio, Finland.,Department of Cardiothoracic Surgery, Heart Center, Kuopio University Hospital, Kuopio, Finland.,Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
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8
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Zhu Y, Zhang XE, Li Q, Yao H. Three-dimensional printing in a patient with pulmonary artery pseudoaneurysm and complex congenital heart disease-A case report. Clin Case Rep 2020; 8:2107-2110. [PMID: 33235737 PMCID: PMC7669418 DOI: 10.1002/ccr3.2950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 10/07/2019] [Accepted: 10/21/2019] [Indexed: 11/28/2022] Open
Abstract
3D-printing is a powerful tool in patients with complex anatomy undergoing cardiac surgery.
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Affiliation(s)
- Yueqian Zhu
- Cardiovascular CenterThe 2nd affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Xun E. Zhang
- Cardiovascular CenterThe 2nd affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Qingguo Li
- Cardiovascular CenterThe 2nd affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Hao Yao
- Cardiovascular CenterThe 2nd affiliated Hospital of Nanjing Medical UniversityNanjingChina
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9
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Pulmonary artery aneurysm as a result of group 2 pulmonary artery hypertension in a patient with significant mitral and aortic valve disease - review and case report. POLISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2020; 17:143-148. [PMID: 33014090 PMCID: PMC7526489 DOI: 10.5114/kitp.2020.99078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 08/01/2020] [Indexed: 12/01/2022]
Abstract
Aneurysms are uncommon, but potentially life-threatening abnormalities of the pulmonary arteries. Aneurysm of the main pulmonary artery (MPA) defined as MPA diameter over 40 mm was reported in 1 : 14 000 autopsies. The most frequent location is the main pulmonary artery (89% of cases), whereas the maximum described diameter is 106–170 mm. Clinical manifestations are usually nonspecific or asymptomatic. Right heart failure symptoms, pulmonary regurgitation, trachea or bronchi compression or pulmonary emboli caused by enlarged MPA are the most commonly described clinical manifestations. Pulmonary artery aneurysm dissection is an uncommon complication but associated with a high mortality rate. Unfortunately, guidelines regulating the optimal time for the surgical intervention still have not been developed. We present the history of 76-year-old patient suffering from an aneurysm of the pulmonary artery (74 × 61 mm), as well as mitral and aortic valve disease, who was successfully operated on in our hospital.
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10
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Di Nora C, Pecoraro R, Evangelista A, Antonini-Canterin F. Giant Pulmonary Artery Aneurysm in Bicuspid Pulmonary Valve: Does the Right Side Mimic the Left One? JACC Case Rep 2020; 2:1720-1722. [PMID: 34317043 PMCID: PMC8312132 DOI: 10.1016/j.jaccas.2020.05.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 05/14/2020] [Accepted: 05/29/2020] [Indexed: 11/15/2022]
Abstract
Bicuspid pulmonary valve is a rare echocardiographic finding, particularly if not associated with other congenital heart diseases. We report the incidental case of a severe giant pulmonary arterial aneurysm associated to bicuspid pulmonary valve in an asymptomatic 79-year-old patient. Multimodality cardiac imaging was important for the correct diagnosis and to exclude any other potential complication. (Level of Difficulty: Beginner.)
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Affiliation(s)
- Concetta Di Nora
- Cardiothoracic Department, Azienda Sanitaria Universitaria Integrata, Udine, Italy
| | - Rosa Pecoraro
- Cardiology Department. AAS 5 Friuli Occidentale, Pordenone, Italy
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Nuche J, Montero-Cabezas JM, Lareo A, Huertas S, Jiménez López-Guarch C, Velázquez Martín M, Alonso Charterina S, Revilla Ostolaza Y, Delgado JF, Arribas Ynsaurriaga F, Escribano Subías P. Influence of long-standing pulmonary arterial hypertension and its severity on pulmonary artery aneurysm development. Heart Vessels 2020; 35:1290-1298. [DOI: 10.1007/s00380-020-01600-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/27/2020] [Indexed: 11/30/2022]
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12
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Ishiyama D, Makino E, Nakamura Y, Uchida M, Onodera Y, Chambers JK, Uchida K, Matsuda F. Clinical and postmortem findings of pentalogy of Fallot in an 18-month-old Holstein heifer. J Vet Med Sci 2019; 81:1676-1679. [PMID: 31582644 PMCID: PMC6895641 DOI: 10.1292/jvms.19-0147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
An 18-month-old female Holstein Friesian heifer presented with a history of stunted growth and a recent onset of anorexia; she presented with cyanosis and eventually died. A postmortem examination revealed obstruction of the right ventricular outflow tract, ventricular septal defect, overriding aortic root, right ventricular hypertrophy, and an atrial septal defect, indicating a pentalogy of Fallot (POF). In addition to POF, the heifer also had pulmonary artery dilatation, although she did not present with patent ductus arteriosus. This heifer had the longest lifespan among the Holstein cattle reported to have POF, which may be secondary to delayed pulmonary obstruction due to deformation of one of the pulmonary valves.
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Affiliation(s)
- Dai Ishiyama
- Sekiyado Branch Office, Western Veterinary Clinical Center, Chiba Prefectural Federated Agricultural Mutual Aid Association, 462-11 Kirigasaku, Noda-shi, Chiba 270-0213, Japan
| | - Eiji Makino
- Sekiyado Branch Office, Western Veterinary Clinical Center, Chiba Prefectural Federated Agricultural Mutual Aid Association, 462-11 Kirigasaku, Noda-shi, Chiba 270-0213, Japan
| | - Yoshihiro Nakamura
- Sekiyado Branch Office, Western Veterinary Clinical Center, Chiba Prefectural Federated Agricultural Mutual Aid Association, 462-11 Kirigasaku, Noda-shi, Chiba 270-0213, Japan
| | - Makoto Uchida
- Sekiyado Branch Office, Western Veterinary Clinical Center, Chiba Prefectural Federated Agricultural Mutual Aid Association, 462-11 Kirigasaku, Noda-shi, Chiba 270-0213, Japan
| | - Yukio Onodera
- Sekiyado Branch Office, Western Veterinary Clinical Center, Chiba Prefectural Federated Agricultural Mutual Aid Association, 462-11 Kirigasaku, Noda-shi, Chiba 270-0213, Japan
| | - James K Chambers
- Department of Veterinary Medical Sciences, Graduate School of Agriculture and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Kazuyuki Uchida
- Department of Veterinary Medical Sciences, Graduate School of Agriculture and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Fuko Matsuda
- Department of Veterinary Medical Sciences, Graduate School of Agriculture and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
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Huang J, Li X, Liu P, Wang J, Li H. Retracted: Emodin protects H9c2 cells against hypoxia-induced injury via regulation of miR-26a/survivin and the JAK1/STAT3 pathway. J Cell Biochem 2019; 120:11081-11090. [PMID: 30701574 DOI: 10.1002/jcb.28385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 01/10/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND/AIM Congenital heart disease (CHD) is a catastrophic disease. Emodin possesses biological properties in protecting against some diseases. Our study investigated to explore the effects of emodin on hypoxia-stimulated cardiomyocytes, which mimicked CHD in vitro. METHODS H9c2 cells were stimulated with hypoxia and then the cells were treated with or without emodin, and/or transfected with miR-26a mimic, pcDNA-survivin and their corresponding negative control (NC). Cell viability and cell apoptosis were detected by Cell Counting kit-8 assay and flow cytometry, respectively. In addition, the expression of apoptotic proteins, Janus kinase 1 (JNK)/signal transducer and activator of transcription 3 (STAT3) pathway factors, and survivin were evaluated by using Western blot analysis. The expression of miR-26a was analyzed by quantitative real time polymerase chain reaction (qRT-PCR). Moreover, the target of miR-26a was verified by using a luciferase report assay. RESULTS Hypoxia significantly decreased cell viability and increased cell apoptosis, and the accumulated levels of cleaved caspase-3 and cleaved-caspase-9 were upregulated by hypoxia compared with the control. However, emodin administration led to the opposite result. A further result showed that emodin increased the phosphorylation of JNK/STAT3 pathway-related proteins and the pathway inhibitor AG490 impaired the protective effects of emodin on hypoxia-induced injury. In addition, emodin negatively regulated the miR-26a expression, and overexpression of miR-26a enhanced cell apoptosis and upregulated the expression of cleaved-caspase-3 and cleaved-caspase-9 compared with the NC. Moreover, emodin statistically upregulated the expression of survivin, and overexpression of miR-26a decreased the expression of survivin. The luciferase of miR-26a overexpression was decreased in the wild type of the survivin group. CONCLUSION Emodin protects hypoxia-induced cell injury as evidenced by increasing cell viability and decreasing apoptosis through downregulation of miR-26a as well as activation of the JNK/STAT3 pathway.
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Affiliation(s)
- Jiancheng Huang
- Department of Congenital Heart Disease, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Xiaobing Li
- Department of Congenital Heart Disease, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Pujuan Liu
- Department of Congenital Heart Disease, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Jun Wang
- Department of Congenital Heart Disease, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Hongying Li
- Department of Congenital Heart Disease, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
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Greutmann M. Pulmonary artery dilatation in congenital heart disease: Size doesn't matter. Int J Cardiol 2019; 277:235-236. [DOI: 10.1016/j.ijcard.2018.08.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 08/20/2018] [Indexed: 10/28/2022]
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15
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Simakova MA, Marukyan NV, Gukov KD, Zverev DA, Moiseeva OM. Left main coronary artery compression by pulmonary artery aneurism in patients with long standing pulmonary arterial hypertension. ACTA ACUST UNITED AC 2018; 58:22-32. [PMID: 30625087 DOI: 10.18087/cardio.2580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 12/14/2018] [Indexed: 11/18/2022]
Abstract
This review focuses on a rare complication of pulmonary arterial hypertension (PAH), extravasation compression of the left coronary artery (LCA) dilated by the pulmonary artery. The review described clinical manifestations and methods for diagnostics of LCA compression, and advantages of the endovascular correction of this complication in patients with pulmonary hypertension. Selection of a device to be implanted during the endovascular intervention in these patients was discussed with due account for concomitant treatment with oral anticoagulants. As an illustration of the issue under discussion, a clinical case of acute coronary syndrome in a female patient from the PAH Registry of the V. A. Almazov National Medical Research Center was provided.
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