1
|
Habib PA, Bae S, Turan S, Sundararajan S. Congenital Bilateral Branch Pulmonary Artery Hypoplasia: Prenatal Diagnosis and Parental Counseling. Neoreviews 2023; 24:e829-e835. [PMID: 38036449 DOI: 10.1542/neo.24-12-e829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Affiliation(s)
- Paola Abi Habib
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Science, University of Maryland School of Medicine, Baltimore, MD
| | - Sarra Bae
- Division of Neonatology, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD
| | - Sifa Turan
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Science, University of Maryland School of Medicine, Baltimore, MD
| | - Sripriya Sundararajan
- Division of Neonatology, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD
| |
Collapse
|
2
|
Tamura Y, Tamura Y, Shigeta A, Hosokawa K, Taniguchi Y, Inami T, Adachi S, Tsujino I, Nakanishi N, Sato K, Sakamoto J, Tanabe N, Takama N, Nakamura K, Kubota K, Komura N, Kato S, Yamashita J, Takei M, Joho S, Ishii S, Takemura R, Sugimura K, Tatsumi K. Adult-onset idiopathic peripheral pulmonary artery stenosis. Eur Respir J 2023; 62:2300763. [PMID: 38061784 PMCID: PMC10733597 DOI: 10.1183/13993003.00763-2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 10/20/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Peripheral pulmonary artery stenosis (PPS) refers to stenosis of the pulmonary artery from the trunk to the peripheral arteries. Although paediatric PPS is well described, the clinical characteristics of adult-onset idiopathic PPS have not been established. Our objectives in this study were to characterise the disease profile of adult-onset PPS. METHODS We collected data in Japanese centres. This cohort included patients who underwent pulmonary angiography (PAG) and excluded patients with chronic thromboembolic pulmonary hypertension or Takayasu arteritis. Patient backgrounds, right heart catheterisation (RHC) findings, imaging findings and treatment profiles were collected. RESULTS 44 patients (median (interquartile range) age 39 (29-57) years; 29 females (65.9%)) with PPS were enrolled from 20 centres. In PAG, stenosis of segmental and peripheral pulmonary arteries was observed in 41 (93.2%) and 36 patients (81.8%), respectively. 35 patients (79.5%) received medications approved for pulmonary arterial hypertension (PAH) and 22 patients (50.0%) received combination therapy. 25 patients (56.8%) underwent transcatheter pulmonary angioplasty. RHC data showed improvements in both mean pulmonary arterial pressure (44 versus 40 mmHg; p<0.001) and pulmonary vascular resistance (760 versus 514 dyn·s·cm-5; p<0.001) from baseline to final follow-up. The 3-, 5- and 10-year survival rates of patients with PPS were 97.5% (95% CI 83.5-99.6%), 89.0% (95% CI 68.9-96.4%) and 67.0% (95% CI 41.4-83.3%), respectively. CONCLUSIONS In this study, patients with adult-onset idiopathic PPS presented with segmental and peripheral pulmonary artery stenosis. Although patients had severe pulmonary hypertension at baseline, they showed a favourable treatment response to PAH drugs combined with transcatheter pulmonary angioplasty.
Collapse
Affiliation(s)
- Yudai Tamura
- Cardiovascular Center, International University of Health and Welfare School of Medicine, Narita, Japan
- Pulmonary Hypertension Center, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Yuichi Tamura
- Cardiovascular Center, International University of Health and Welfare School of Medicine, Narita, Japan
- Pulmonary Hypertension Center, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Ayako Shigeta
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kazuya Hosokawa
- Faculty of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yu Taniguchi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Takumi Inami
- Department of Cardiovascular Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Shiro Adachi
- Department of Cardiology, Nagoya University Hospital, Aichi, Japan
| | - Ichizo Tsujino
- Division of Respiratory and Cardiovascular Innovative Research, Faculty of Medicine, Hokkaido University, Hokkaido, Japan
| | - Naohiko Nakanishi
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kimi Sato
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Jiro Sakamoto
- Department of Cardiology, Tenri Hospital, Tenri, Japan
| | - Nobuhiro Tanabe
- Pulmonary Hypertension Center, Chibaken Saiseikai Narashino Hospital, Narashino, Japan
| | - Noriaki Takama
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Kazuto Nakamura
- Department of Cardiology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Kayoko Kubota
- Departments of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Naohiro Komura
- Department of Cardiology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Shigehiko Kato
- Department of Cardiology, Pulmonology and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
| | - Jun Yamashita
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan
| | - Makoto Takei
- Department of Cardiology, Saiseikai Central Hospital, Tokyo, Japan
| | - Shuji Joho
- The Second Department of Internal Medicine, University of Toyama, Toyama, Japan
| | - Shunsuke Ishii
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Kanagawa, Japan
| | - Ryo Takemura
- Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Koichiro Sugimura
- Department of Cardiology, International University of Health and Welfare, Narita Hospital, Narita, Japan
| | - Koichiro Tatsumi
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| |
Collapse
|
4
|
He F, Wang X, Hua L, Guo T. Numerical analysis of hemodynamics in pulmonary artery stenosis. Biomed Mater Eng 2022; 34:235-246. [DOI: 10.3233/bme-221418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Pulmonary artery stenosis is a serious threat to people’s life and health. OBJECTIVE: The hydrodynamic mechanism of pulmonary artery stenosis is investigated. METHODS: Numerical analysis of hemodynamics in pulmonary artery stenosis using computational fluid dynamics techniques is a well-established method. An idealized model of pulmonary stenosis is established, and the model is divided into main pulmonary artery, right and left pulmonary arteries, and their branches. The sections at different positions are intercepted to study the distribution trend of maximum velocity, pressure and wall shear stress. RESULTS: The numerical simulation results show that the pressure drop at both ends of the narrow is large. High velocity and wall shear stress exist in the center of stenosis, and the wall shear stress at the distal end of stenosis gradually decreases, resulting in endothelial dysfunction. CONCLUSIONS: To some extent, this study helps clinicians make diagnosis and treatment plans in advance and improve prognosis. This method could be used in the numerical simulation of practical models.
Collapse
Affiliation(s)
- Fan He
- School of Science, , , China
| | | | - Lu Hua
- , , State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, , , China
| | - Tingting Guo
- , , State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, , , China
| |
Collapse
|
5
|
Hosseini Z, Firouzi A, Mohebbi B, Khalilipur E, Baay M, Kalantari KR, Harirforoosh I, Khajali Z. The treatment dilemma in adult patients with peripheral pulmonary artery stenosis of diverse etiologies. Egypt Heart J 2021; 73:65. [PMID: 34264403 PMCID: PMC8282849 DOI: 10.1186/s43044-021-00190-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 07/05/2021] [Indexed: 11/18/2022] Open
Abstract
Background Peripheral pulmonary artery stenosis (PPAS) is a rare and underdiagnosed phenomenon that is reported infrequently in adult patients. Most patients with PPAS have concomitant congenital heart diseases, a history of palliative surgical therapies during childhood, or syndromic characteristics. Acquired cases are rare, and they are underestimated in adulthood and managed inappropriately. Case presentation This case series describes 3 adult patients with PPAS of diverse etiologies and discusses their underlying causes, diagnostic modalities, and treatment strategies. Conclusions In patients with PPAS, sufficient heed should be paid to endovascular interventions such as balloon dilation and primary or bailout stenting, not least vis-à-vis the type and size of balloons or stents as well as complications and preventive strategies.
Collapse
Affiliation(s)
- Zahra Hosseini
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ata Firouzi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Bahram Mohebbi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ehsan Khalilipur
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Baay
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-Asr Ave, Tehran, 1996911101, Iran
| | - Kiara Rezaei Kalantari
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-Asr Ave, Tehran, 1996911101, Iran
| | - Iman Harirforoosh
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-Asr Ave, Tehran, 1996911101, Iran
| | - Zahra Khajali
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-Asr Ave, Tehran, 1996911101, Iran.
| |
Collapse
|