Complications of Proximal Pulmonary Artery Aneurysms in Patients With Severe Pulmonary Arterial Hypertension

Hernández, Verónica; Ruiz-Cano, María J.; Escribano, Pilar; Sánchez, Miguel A. Gómez

doi:10.1016/s1885-5857(10)70128-6

Cited by 10 publications

(10 citation statements)

References 6 publications

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“…11 The reported prevalence of PA aneurysms varied from 1.3% to 24%. 4,[12][13][14][15][16] Of 1192 patients with PA dilatation in association with PHT, 153 had a PA aneurysm. In none of the studies, an association between PA dilatation and prognosis was found.…”

Section: High-pressure Pulmonary Artery Aneurysmmentioning

confidence: 99%

Aneurysm of the Pulmonary Artery, a Systematic Review and Critical Analysis of Current Literature

Duijnhouwer

Navarese

Dijk

et al. 2015

Congenital Heart Disease

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Section: High-pressure Pulmonary Artery Aneurysmmentioning

confidence: 99%

Aneurysm of the Pulmonary Artery, a Systematic Review and Critical Analysis of Current Literature

Duijnhouwer

Navarese

Dijk

et al. 2015

Congenital Heart Disease

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“…Intensive medical treatment has been one possible approach for PA aneurysms with clinical improvement of signs and symptoms [4,8,9] and so treatment for PH was started. However, despite being responsive to therapy with calcium channel blockers and near normalization of pulmonary vascular resistance, the aneurysm showed no size reduction after 20 months of treatment, suggesting that PH and PA aneurysms progress independently.…”

Section: Case Presentationmentioning

confidence: 99%

Giant pulmonary artery aneurysm in a patient with vasoreactive pulmonary hypertension: a case report

Araújo

Escribano

López-Gude

et al. 2011

BMC Cardiovasc Disord

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BackgroundPulmonary artery aneurysms are a rare condition, frequently associated with pulmonary hypertension. However, the evolution and treatment of this pathology is still not clear.Case PresentationThe authors report a case of a 65-year old patient with pulmonary artery aneurysm associated with pulmonary arterial hypertension. Due to a positive vasoreactivity test, treatment with calcium channel blockers was started with near normalization of the right cardiac pressures. Nevertheless, after 20 months of treatment, the pulmonary artery aneurysm size remained unchanged with an associated severe pulmonary regurgitation and causing extrinsic compression of the main left coronary artery. Surgical correction was successfully performed.ConclusionsThis is the first case report of a pulmonary artery aneurysm described to be associated with vasoreactive pulmonary hypertension in a living patient. Although medical therapy for pulmonary hypertension was started, surgical correction of the aneurysm was executed in order to prevent its future complications.

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“…4 In patients like ours, with unaffordable surgical risk and critical stenosis of the LMCA that produces severe symptoms, percutaneous revascularization and intensification of specific PH treatment may be a reasonable option.…”

Section: Images In Cardiovascular Medicinementioning

confidence: 88%

Compression of the Left Main Coronary Artery by a Giant Pulmonary Artery Aneurysm

et al. 2013

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W e present a 70-year--old man who had a past medical history of dilated idiopathic pulmonary artery, incidentally diagnosed at the age of 23 years. He was asymptomatic until a year ago when he was admitted for an episode of anginal chest pain in the context of paroxysmal atrial fibrillation. At rapid rates, he showed pathological ST segment descent. A coronary angiography showed a slight stenosis of the left main coronary artery (LMCA). At that time, the mean pulmonary artery pressure was 36 mm Hg. After recovering sinus rhythm, the patient became asymptomatic and was discharged with β-blockers.A year later, the patient was admitted with resting angina. The echocardiogram ( Figure A) and the computed tomography-angio showed that the aneurysm had increased to 80 mm and compressed the LMCA (Figure B). This finding was confirmed on coronary angiography and intravascular ultrasound that showed a critical stenosis of LMCA ( Figure C, insert 1, and online-only Data Supplement Movie I) and normal luminal diameter of anterior descending artery ( Figure C, insert 2). In addition, the mean pulmonary artery pressure had increased >60 mm Hg.Because of the high surgical risk posed aneurysm surgery, percutaneous revascularization of LMCA with drug-eluting stent was performed with good final result ( Figure D, insert 1, and online-only Data Supplement Movie II). We also initiated specific treatment of pulmonary hypertension (PH) with phosphodiesterase-5 inhibitors and an endothelin receptor antagonist. The patient became asymptomatic and was discharged to reevaluate the surgical indication of aneurysm according to the clinical and PH evolution in the follow-up. One year later, the patient is asymptomatic with no adverse events.Extrinsic compressions of LMCA by a pulmonary artery aneurysm are extremely rare and usually associated with PH. Only case reports and small series have described this entity as a cause of angina and sudden death, and, currently, the appropriate management of these patients remains unknown.

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Complications of Proximal Pulmonary Artery Aneurysms in Patients With Severe Pulmonary Arterial Hypertension

Cited by 10 publications

References 6 publications

Aneurysm of the Pulmonary Artery, a Systematic Review and Critical Analysis of Current Literature

Aneurysm of the Pulmonary Artery, a Systematic Review and Critical Analysis of Current Literature

Giant pulmonary artery aneurysm in a patient with vasoreactive pulmonary hypertension: a case report

Compression of the Left Main Coronary Artery by a Giant Pulmonary Artery Aneurysm

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