Compression of left main bronchus and left pulmonary artery by thoracic aortic aneurysm

Abstract

We describe a patient in whom an aneurysm of the transverse thoracic aorta extended inferiorly into the aortopulmonary window with compression of the left mainstem bronchus and left pulmonary artery. Plain film findings revealed aneurysmal dilatation of the thoracic aorta, progressive atelectasis of the left lung, and a mass in the aortopulmonary window.CT and MA imaging showed that the obstructing lesion was a saccular aortic aneurysm with mural thrombus. Case ReportA 71-year-old man with longstanding systemic hypertension had a gradual onset of persistent cough and hoarseness over several months. He had no previous history of syphilis or thoracic trauma. CT of the chest, done to evaluate the thoracic aorta and exclude a mediastinal neoplasm, showed a 5-cm mass adjacent to the inferior aspect of the transverse thoracic aorta. The mass had peripheral calcification and its superior portion enhanced to the same degree as the aorta (Fig. 1C). Inferiorly, the mass was less dense than aorta (Fig. 1D) (Fig. 1F)

Anesthetic management in a patient with type A aortic dissection and superior vena cava syndrome

“…An ongoing expansion of a thoracic aortic aneurysm can compress the surrounding structures including the esophagus, superior vena cava or innominate vain and large airways. Moreover, compression of the left main bronchus, left pulmonary artery, trachea or mainstem bronchus has been reported ( 11 , 12 ). As a result, these patients should be carefully examined and evaluated before surgery.…”