Dilated right pulmonary veins in mitral insufficiency

Pulmonary varix: magnetic resonance findings

The magnetic resonance appearance of a confluent-type pulmonary varix is correlated with computed tomography and angiographic findings. This case demonstrates the usefulness of magnetic resonance in the evaluation of cardiovascular lesions.

Regional distribution of lung perfusion and ventilation in patients with chronic congestive heart failure and its relationship to cardiopulmonary hemodynamics

To study the relationship between the distribution of pulmonary blood flow, pulmonary ventilation, and pulmonary capillary wedge pressure, we studied six patients with chronic congestive heart failure (CHF) (New York Heart Association classes II and III) at rest and during exercise. We used krypton 81m (81mKr) and technetium 99m (99mTc) to assess lung ventilation and perfusion at rest and during exercise. Hemodynamic measurements were obtained with a balloon floatation thermodilution catheter. At rest, the upper lung zones of patients with CHF received significantly higher proportions of the blood flow compared with previously published data in normal volunteers. During exercise, however, the fractional perfusion to apices did not change, which suggests that apical flow redistribution is already maximized at rest. Measured pulmonary capillary wedge pressure failed to correlate with the upper zone or the ratio of upper-to-lower zone perfusion counts. Our findings suggest that upper zone flow redistribution may be associated with high, normal, or low capillary wedge pressure and therefore does not correlate with the pulmonary capillary wedge pressure in patients with chronic CHF.

Pulmonary varices: a case report and review of the literature

A case of a 47-year-old woman with pulmonary varix is reported herein. Saccular dilatation of the inferior pulmonary vein resembled a pulmonary perihilar mass which could not be palpated at the time of thoracotomy. Aneurysmal dilatation of the pulmonary vein, otherwise known as pulmonary varix, is rare. Only 71 such cases, including 17 cases in Japan, have been reported. Pulmonary varices may be classified into three types, namely: saccular type, tortuous type and confluent type. Most of the varices seen in patients with valvular disease have been of the confluent type (62 per cent), however tortuous type varices have also been seen in some cases (19 per cent). Pulmonary venous hypertension may be one of the major causes of confluent type pulmonary varices as regression of pulmonary varices after mitral valve replacement has been reported. None of the saccular type cases, however, were accompanied by valvular disease. This indicates that local factors may also be an important cause of saccular type varices.

Dilated pulmonary venous confluence presenting as a mass in mitral stenosis

Pulmonary varices are rare venous anomalies which typically present as masses. Since they are usually clinically insignificant, varices must be diagnostically distinguished from parenchymal tumors and mediastinal adenopathy so one may adhere to a conservative medical approach. This report reviews the literature and illustrates a convergence of varices that presented as a larger sized mass than previously described by others.

Pulmonary varices associated with mitral valve disease: a case report and survey of the literature

A case of pulmonary varices in a 24-year-old man with mitral regurgitation is reported. A brief summary of the literature on pulmonary varices associated with mitral valve disease is presented, with special reference to its etiology and surgical treatment. It is strongly suggested that production of varicosities of the pulmonary vein requires not only increased pulmonary venous pressure but also other local factors. If the patient has symptoms due to mitral regurgitation, operation for mitral valve disease is indicated. Direct operative intervention for the varices should not be performed.

Pulmonary varix regression after mitral valve replacement

Pulmonary varix is a rare finding; only 35 documented cases have been reported. The first case was described in 1843 as an icidental postmortem finding. The first clinical diagnosis was not made until 1951. In more than half of the 35 cases, the varix was present in the absence of congenital and acquired heart disease. Six patients have had concomitant mitral rheumatic heart disease. This communication describes the second patient with rheumatic mitral regurgitation in whom the pulmonary varix became radiographically invisible after prosthetic mitral valve replacement.

Pulmonary varix

Pulmonary varix is a rare disorder which is usually discovered by change during the third to sixth decade in an asymptomatic patient. The 37th example is reported with a review of the literature. The disorder is possibly congenital and may affect any lobe. Pulmonary angiography is the preferred procedure for diagnosis. If symptoms are present, they can usually attributed to associated cardiopulmonary disease. Two serious complications have been reported--systematic embolus from a clot in the varix (two cases suspected), and rupture leading to the death of the patient (four cases). A third hazard to the patient is an unnecessary diagnostic thoracotomy. Patients without symptoms should have periodic chest radiographs of those with haemoptysis or systemic embolism should be considered for resection of the varix.