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Savic V, Rahmanian LB, Renner T, Emmert MY, Mestres CA. Acute Pulmonary Artery Dissection With an Ongoing Extrinsic Myocardial Infarction. JACC Case Rep 2019; 1:376-380. [PMID: 34316829 PMCID: PMC8289138 DOI: 10.1016/j.jaccas.2019.07.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 07/26/2019] [Accepted: 07/28/2019] [Indexed: 11/19/2022]
Abstract
A patient with chronic pulmonary artery hypertension and acute dissection of a main and right pulmonary aneurysm (82 mm) presented with acute myocardial infarction and cardiogenic shock secondary to compression of the left main coronary artery. She required emergency pulmonary artery replacement. She ultimately died due to multiorgan failure and sepsis. (Level of Difficulty: Intermediate.).
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Affiliation(s)
| | | | | | | | - Carlos A. Mestres
- Address for correspondence: Dr. Carlos A. Mestres, Department of Cardiovascular Surgery, University Hospital Zürich, Rämistrasse 100, CH-80981 Zürich, Switzerland.
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Fernando DMG, Thilakarathne SMNK, Wickramasinghe CU. Pulmonary artery dissection—A review of 150 cases. Heart Lung 2019; 48:428-435. [DOI: 10.1016/j.hrtlng.2019.02.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 02/13/2019] [Accepted: 02/25/2019] [Indexed: 12/17/2022]
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Tandon R, Gupta H, Wander G, Goyal A. Pericardial tamponade due to main pulmonary artery dissection in a young patient with eisenmenger's syndrome. JOURNAL OF THE INDIAN ACADEMY OF ECHOCARDIOGRAPHY & CARDIOVASCULAR IMAGING 2019. [DOI: 10.4103/jiae.jiae_8_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Florczyk M, Wieteska M, Kurzyna M, Gościniak P, Pepke-Żaba J, Biederman A, Torbicki A. Acute and chronic dissection of pulmonary artery: new challenges in pulmonary arterial hypertension? Pulm Circ 2017; 8:2045893217749114. [PMID: 29251549 PMCID: PMC5896856 DOI: 10.1177/2045893217749114] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Right ventricular failure is a leading cause of mortality in patients with pulmonary arterial hypertension (PAH). However, up to 25% of such patients die unexpectedly, without warning signs of hemodynamical decompensation. We previously documented that pulmonary artery (PA) dilatation significantly increases the risk of those deaths. Some of them may be due to dissection of PA resulting in cardiac tamponade. However, direct confirmation of this mechanism is difficult as most of such deaths occur outside hospitals. We present 4 patients with severe PAH and PA dilatation in whom PA dissection has been confirmed. Three patients had IPAH, one had PAH associated with congenital heart disease. All patients had mean pulmonary artery pressure (PAP) > 50 mmHg at diagnosis and dissection occurred late in the course of apparently well controlled disease (6 to 14 years). Several clinical elements were common to our patients - high systolic PAP, long lasting PH, progressive dilatation of PA to more than 50 mm with chest pain prior to dissection. However, clinical course followed three different patterns: sudden death due to cardiac tamponade, hemopericarditis caused by blood leaking from dissected aneurysm with imminent but not immediate cardiac tamponade, or chronic asymptomatic PA dissection. Indeed, two of our patients are alive and on lung transplantation waiting list for more than 2 years now. Further research is needed to suggest optimal management strategies for patients with stable PAH but significantly dilated proximal pulmonary arteries or confirmed PA dissection depending on the clinical presentation and expected outcome.
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Affiliation(s)
- Michał Florczyk
- 1 Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, European Health Centre Otwock, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Maria Wieteska
- 1 Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, European Health Centre Otwock, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Marcin Kurzyna
- 1 Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, European Health Centre Otwock, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Piotr Gościniak
- 2 Clinical and Invasive Cardiology Department, Maria Curie Skłodowska Province Hospital, Szczecin, Poland
| | - Joanna Pepke-Żaba
- 3 Pulmonary Vascular Diseases Unit, Papworth Hospital, Cambridge, UK
| | | | - Adam Torbicki
- 1 Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, European Health Centre Otwock, Centre of Postgraduate Medical Education, Warsaw, Poland
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Pulmonary artery dissection in a patient with undiagnosed pulmonary hypertension – A case report and review of literature. Heart Lung 2015; 44:453-7. [DOI: 10.1016/j.hrtlng.2015.06.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 06/07/2015] [Accepted: 06/09/2015] [Indexed: 11/23/2022]
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Sheikhzadeh S, De Backer J, Gorgan NR, Rybczynski M, Hillebrand M, Schüler H, Bernhardt AM, Koschyk D, Bannas P, Keyser B, Mortensen K, Radke RM, Mir TS, Kölbel T, Robinson PN, Schmidtke J, Berger J, Blankenberg S, von Kodolitsch Y. The main pulmonary artery in adults: a controlled multicenter study with assessment of echocardiographic reference values, and the frequency of dilatation and aneurysm in Marfan syndrome. Orphanet J Rare Dis 2014; 9:203. [PMID: 25491897 PMCID: PMC4272795 DOI: 10.1186/s13023-014-0203-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 11/26/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Echocardiographic upper normal limits of both main pulmonary artery (MPA) diameters (MPA-d) and ratio of MPA to aortic root diameter (MPA-r) are not defined in healthy adults. Accordingly, frequency of MPA dilatation based on echocardiography remains to be assessed in adults with Marfan syndrome (MFS). METHODS We enrolled 123 normal adults (72 men, 52 women aged 42 ± 14 years) and 98 patients with MFS (42 men, 56 women aged 39 ± 14 years) in a retrospective cross-sectional observational controlled study in four tertiary care centers. We defined outcome measures including upper normal limits of MPA-d and MPA-r as 95 quantile of normal persons, MPA dilatation as diameters > upper normal limits, MPA aneurysm as diameters >4 cm, and indication for surgery as MPA diameters >6 cm. RESULTS MPA diameters revealed normal distribution without correlation to age, sex, body weight, body height, body mass index and body surface area. The upper normal limit was 2.6 cm (95% confidence interval (CI) =2.44-2.76 cm) for MPA-d, and 1.05 (95% CI = .86-1.24) for MPA-r. MPA dilatation presented in 6 normal persons (4.9%) and in 68 MFS patients (69.4%; P < .001), MPA aneurysm presented only in MFS (15 patients; 15.3%; P < .001), and no patient required surgery. Mean MPA-r were increased in MFS (P < .001), but ratios >1.05 were equally frequent in 7 normal persons (5%) and in 8 MFS patients (10.5%; P = .161). MPA-r related to aortic root diameters (P = .042), reduced left ventricular ejection fraction (P = .006), and increased pulmonary artery systolic pressures (P = .040). No clinical manifestations of MFS and no FBN1 mutation characteristics related to MPA diameters. CONCLUSIONS We established 2.6 cm for MPA-d and 1.05 for MPA-r as upper normal limits. MFS exhibits a high prevalence of MPA dilatation and aneurysm. However, patients may require MPA surgery only in scarce circumstances, most likely because formation of marked MPA aneurysm may require LV dysfunction and increased PASP.
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Affiliation(s)
- Sara Sheikhzadeh
- Centre of Cardiology and Cardiovascular Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Julie De Backer
- Centre for Medical Genetics, University Hospital Ghent, Ghent, Belgium.
| | - Neda Rahimian Gorgan
- Centre of Cardiology and Cardiovascular Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Meike Rybczynski
- Centre of Cardiology and Cardiovascular Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Mathias Hillebrand
- Centre of Cardiology and Cardiovascular Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Helke Schüler
- Centre of Cardiology and Cardiovascular Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Alexander M Bernhardt
- Centre of Cardiology and Cardiovascular Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Dietmar Koschyk
- Centre of Cardiology and Cardiovascular Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Peter Bannas
- Department of Diagnostic and Interventional Radiology, University Hospital Eppendorf, Hamburg, Germany.
| | - Britta Keyser
- Institute of Human Genetics, Hannover Medical School, Hannover, Germany.
| | - Kai Mortensen
- Medizinische Klinik II / Kardiologie, Angiologie, am Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Germany.
| | - Robert M Radke
- Department für Kardiologie und Angiologie, Universitätsklinikum Münster, Münster, Germany.
| | - Thomas S Mir
- Centre of Cardiology and Cardiovascular Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Tilo Kölbel
- Centre of Cardiology and Cardiovascular Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Peter N Robinson
- Institute of Medical Genetics, Charité Universitätsmedizin Berlin, Berlin, Germany.
| | - Jörg Schmidtke
- Institute of Human Genetics, Hannover Medical School, Hannover, Germany.
| | - Jürgen Berger
- Department of Medical Biometry and Epidemiology, University Hospital Eppendorf, Hamburg, Germany.
| | - Stefan Blankenberg
- Centre of Cardiology and Cardiovascular Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Yskert von Kodolitsch
- Centre of Cardiology and Cardiovascular Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
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Hostiuc S, Dermengiu D, Ceauşu M, Capatina CO, Luca L, Hostiuc M. Sudden death due to dissection of the thoracic aorta associated with dissection and rupture of the pulmonary artery: Report of two cases. Forensic Sci Int 2014; 236:e9-13. [DOI: 10.1016/j.forsciint.2013.12.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2013] [Accepted: 12/20/2013] [Indexed: 10/25/2022]
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Corrêa RDA, Silva LCDS, Rezende CJ, Bernardes RC, Prata TA, Silva HL. Pulmonary hypertension and pulmonary artery dissection. J Bras Pneumol 2013; 39:238-41. [PMID: 23670510 PMCID: PMC4075813 DOI: 10.1590/s1806-37132013000200016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Accepted: 12/07/2012] [Indexed: 11/22/2022] Open
Abstract
Pulmonary artery dissection is a fatal complication of long-standing pulmonary hypertension, manifesting as acute, stabbing chest pain, progressive dyspnea, cardiogenic shock, or sudden death. Its incidence has been underestimated, and therapeutic options are still scarce. In patients with pulmonary hypertension, new chest pain, acute chest pain, or cardiogenic shock should raise the suspicion of pulmonary artery dissection, which can result in sudden death.
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Affiliation(s)
- Ricardo de Amorim Corrêa
- Department of Pulmonology and Thoracic Surgery, Federal University of Minas Gerais School of Medicine Hospital das Clínicas, Belo Horizonte, Brazil.
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Giant pulmonary artery aneurysm with dissection in a case of Marfan syndrome. J Am Coll Cardiol 2013; 61:685. [PMID: 23391202 DOI: 10.1016/j.jacc.2012.07.077] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 07/12/2012] [Accepted: 07/17/2012] [Indexed: 11/24/2022]
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A rare case of right and left pulmonary artery dissections on 64-slice multidetector computed tomography. J Thorac Imaging 2010; 25:W136-7. [PMID: 20531230 DOI: 10.1097/rti.0b013e3181c65af5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Pulmonary artery dissection is a rare but life-threatening disease, which has mainly been diagnosed at postmortem examination rather than in living patients. Herein we report an unusual case of pulmonary artery dissection involving the right and left pulmonary arteries with Eisenmenger syndrome confirmed by multidetector computed tomography (CT) and echocardiography in a living patient. The CT findings of our case are presented, and the utility of multidetector CT in the evaluation of pulmonary artery dissection is discussed.
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Affiliation(s)
- Amikar Sehdev
- Department of Internal Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois 60612, USA.
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12
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Abstract
This article discusses the role of magnetic resonance angiography (MRA) in evaluating the pulmonary arterial system. For depiction of pulmonary arterial anatomy and morphology, MRA techniques are compared with CT angiography and digital subtraction x-ray angiography. Perfusion, flow, and function are emphasized, as the integrated MR examination offers a comprehensive assessment of vascular morphology and function. Advances in MR technology that improve spatial and temporal resolution and compensate for potential artifacts are reviewed as they pertain to pulmonary MRA. Current and emerging gadolinium contrast-enhanced and non-contrast-enhanced MRA techniques are discussed. The role of pulmonary MRA, clinical protocols, imaging findings, and interpretation pitfalls are reviewed for clinical indications.
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Affiliation(s)
- Elizabeth M Hecht
- Department of Radiology, New York University School of Medicine, 560 First Avenue, TCH-HW202, New York, NY 10016, USA.
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13
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Idiopathic pulmonary artery dissection: a case report. J Med Case Rep 2009; 3:7426. [PMID: 19830206 PMCID: PMC2737775 DOI: 10.4076/1752-1947-3-7426] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2008] [Accepted: 01/27/2009] [Indexed: 11/08/2022] Open
Abstract
Introduction The occurrence of pulmonary artery dissection is extremely rare in patients without pulmonary hypertension, congenital cardiac abnormalities or cardiac intervention. A diagnosis of pulmonary artery dissection is rarely made during life because it generally leads to cardiogenic shock and sudden death. The progression or natural course of pulmonary artery dissection is not known and the optimum management is not defined because of the paucity of cases in the literature. Case presentation We report a rare case of a 51-year-old female patient, without pulmonary hypertension or other cardiac abnormalities, who presented with acute chest pain and was found to have a pulmonary artery dissection.. The diagnosis of pulmonary artery dissection was confirmed by computed tomography scan of the chest and cardiac magnetic resonance imaging. The patient declined surgical intervention and was followed up closely with medical therapy. At almost a year after her initial presentation, the patient is stable with no complications. Conclusions To our knowledge, there are no similar cases reported in the literature of people with pulmonary artery dissection who have been followed up and who have not had surgical intervention. We review the etiology, pathophysiology, clinical associations, diagnosis and management of patients with pulmonary artery dissection.
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Mutlu H, Demir IE, Mutlu LN, Doyle D. Pulmonary artery dissection mimicking mediastinal mass. Heart Lung 2009; 38:233-7. [DOI: 10.1016/j.hrtlng.2008.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2008] [Revised: 05/13/2008] [Accepted: 05/23/2008] [Indexed: 10/21/2022]
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Nikolić S, Atanasejević T, Popović V. [Cardiac tamponade due to rupture of healed and sealed aortic intimomedial tear--case report]. SRP ARK CELOK LEK 2007; 135:212-5. [PMID: 17642465 DOI: 10.2298/sarh0704212n] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION The healed and sealed intimomedial aortic tears showed clearly defined edges and U-shaped defect of the tissue extending from intima into the media of a varying depth, filled by paler tissue with smooth surface. These tears can be solitary or multilocular, localized in different parts of the aorta, followed by limited intramural incomplete dissection. They can be provoked by diseases or injury. This part of the aortic wall filled with scar tissue is very vulnerable and could be the site of new rupture, followed by tamponade or fatal internal bleeding. CASE OUTLINE In this paper, we report a case of unexpected unknown death of a young male, 26-years-old, found on the ground, near his car. At autopsy, we established the old healed and open intimomedial tear on the posterior wall of the ascending aorta, with a remaining little dissection flap. This part of the wall with scar tissue was ruptured, causing bleeding in the pericardial sac, and tamponade. Histologically, the early stage of cystic medial degeneration was recognized. There were no injuries of the skin, soft tissue and bones. CONCLUSION In the paper, we discussed the manner of death in this case, as well as the medicolegal implications.
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Neimatallah MA, Hassan W, Moursi M, Al Kadhi Y. CT findings of pulmonary artery dissection. Br J Radiol 2007; 80:e61-3. [PMID: 17548503 DOI: 10.1259/bjr/94062779] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Pulmonary artery dissection is a serious fatal complication of chronic pulmonary arterial hypertension, always occurring at the site of maximal dilatation of the artery. Diagnosis is made mainly at autopsy as many of these patients experience sudden death when the main pulmonary artery dissects into the pericardium, causing acute cardiac tamponade. To our knowledge, five reported cases have described CT imaging findings of acute pulmonary artery dissection in the literature.
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Affiliation(s)
- M A Neimatallah
- Department of Radiology, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia.
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Kholeif MA, Tahir ME, Kholeif YA, Watidy AE. An unusual aneurysm of the main pulmonary artery presenting as acute coronary syndrome. Cardiovasc Intervent Radiol 2006; 29:911-4. [PMID: 16604408 DOI: 10.1007/s00270-005-0178-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A 70-year old man presented with retrosternal chest pain. His electrocardiogram showed nonspecific T wave changes. Cardiac-specific troponin I (cTnI) was elevated. His condition was managed as acute coronary syndrome, following which he had two minor episodes of hemoptysis. A CT pulmonary angiogram showed no evidence of pulmonary embolism, but a large mass lesion was seen in the mediastinum. Echocardiography and cardiac MRI demonstrated a large solid mass, arising from the right ventricular outflow tract and causing compression of the main pulmonary artery (MPA). The differential diagnosis included pericardial and myocardial tumors and clotted aneurysm of the MPA. At surgery, a clotted aneurysmal sac was identified originating from the MPA and the defect was healed. Aneurysms of the MPA are rare. They most commonly present with dyspnea and chest pain. Compression of surrounding structures produces protean manifestations. A high index of suspicion coupled with imaging modalities establishes the diagnosis. Blunt trauma to the chest, at the time of an accident 4 years previously, may explain this aneurysm. The patient's presentation with chest pain was probably due to compression and/or stretching of surrounding structures. Coronary artery compression simulating acute coronary syndrome has been documented in the literature. The rise in cTnI may have been due to right ventricular strain, as a result of right ventricular outflow obstruction by the aneurysm. This has not been reported previously in the literature. The saccular morphology and narrow neck of the aneurysm predisposed to stagnation leading to clotting of the lumen and healing of the tear, which caused the diagnostic difficulty.
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Affiliation(s)
- Mona A Kholeif
- Department of Medicine, King Khalid National Guard Hospital, King Abdul-Aziz Medical City, P.O. Box 9515, Jeddah 21423, Kingdom of Saudi Arabia.
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Khattar RS, Fox DJ, Alty JE, Arora A. Pulmonary artery dissection: an emerging cardiovascular complication in surviving patients with chronic pulmonary hypertension. Heart 2005; 91:142-5. [PMID: 15657218 PMCID: PMC1768672 DOI: 10.1136/hrt.2004.045799] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Pulmonary arterial dissection is an extremely rare and usually lethal complication of chronic pulmonary hypertension. The condition usually manifests as cardiogenic shock or sudden death and is therefore typically diagnosed at postmortem examination rather than during life. However, recent isolated reports have described pulmonary artery dissection in surviving patients. The first case of pulmonary artery dissection in a surviving patient with cor pulmonale caused by chronic obstructive pulmonary disease is presented. The aetiology, pathophysiology, and clinical presentation of pulmonary artery dissection are reviewed and factors that may aid diagnosis during life are discussed.
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Affiliation(s)
- R S Khattar
- Manchester Heart Centre, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK.
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Le Bret E, Lupoglazoff JM, Bachet J, Carbognani D, Bouabdallah K, Folliguet T, Laborde F. Pulmonary Artery Dissection and Rupture Associated With Aortopulmonary Window. Ann Thorac Surg 2004; 78:e67-8. [PMID: 15464456 DOI: 10.1016/j.athoracsur.2004.02.041] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/06/2004] [Indexed: 11/27/2022]
Abstract
A 31-year-old man with uncorrected aortopulmonary window and fixed pulmonary hypertension experienced dissection of the pulmonary artery, rapidly complicated by a fatal spontaneous rupture into the pericardium. In the setting of pulmonary hypertension, the diagnosis of dissection and rupture of the pulmonary artery should be considered in cases of thoracic pain or cardiogenic shock.
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Affiliation(s)
- Emmanuel Le Bret
- Department of Cardiac Pathology, Institut Mutualiste Montsouris, Paris, France.
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