Idiopathic Pulmonary Artery Aneurysm

Deb, Subrato; Zehr, Kenton J.; Shields, Raymond C.

doi:10.1016/j.athoracsur.2004.04.011

Cited by 100 publications

(119 citation statements)

References 6 publications

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“…Alternatively, patients with \60 mm aneurysms, low pulmonary pressure, absence of congenital or acquired significant right shunt or not associated with collagenopathies are considered at low risk, and conservative management is preferred [1][2][3][4].…”

Section: Discussionmentioning

confidence: 99%

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Unusual and voluminous pulmonary trunk aneurysm

2011

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A 65-year-old woman, with hypertension and dyslipidemia, was admitted to our department because of effort dyspnea. The electrocardiogram and physical examination were normal. Transthoracic two-dimensional echocardiography (2DE) showed left and right cardiac chambers with normal dimensions and function (LVEF 65%), mild concentric left ventricle hypertrophy, mild valvular pulmonic stenosis (the continuous-wave Doppler showed a peak velocity of 2.93 m/s, which is consistent with a systolic gradient of 34 mmHg) and aneurysmal dilatation of the main pulmonary artery with extension to the bilateral main branches (Fig. 1). An exercise ECG test showed an inappropriate increase in heart rate and blood pressure at low exercise workloads without ST segment abnormalities. The exercise level was inadequate to test cardiac reserve. A computed tomography (CT) coronary angiography was performed. It showed a voluminous aneurysm (77.6 mm) of the pulmonary artery (Fig. 2), without other cardiac abnormalities. DiscussionPulmonary artery aneurysm (PAAs)-defined as PA dilation greater than 4 cm-is a rare condition, regardless of the cause. The etiology of PAAs can be congenital or acquired. Congenital aneurysms are usually associated with congenital heart diseases causing pulmonary hypertension, and persistent ductus arteriosus is the most frequent. Other congenital causes include atrial and ventricular defects.Acquired causes can be idiopathic or associated with other processes, such as infections (tuberculosis, syphilis), traumatisms, pulmonary valvular stenosis, or diseases affecting collagenous tissue [1,2].In rare cases, when the PAA is not due to a functional or structural anomaly of the cardiovascular system, it is known as an idiopathic PAA.Clinical presentation of a PAA varies. It can be asymptomatic, being a chance finding in a chest X-ray study, echocardiography or computed tomography. In symptomatic patients, dyspnea, hemoptysis and chest pain are the most frequent complaints [1,3].

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Section: Discussionmentioning

confidence: 99%

“…It can be asymptomatic, being a chance finding in a chest X-ray study, echocardiography or computed tomography. In symptomatic patients, dyspnea, hemoptysis and chest pain are the most frequent complaints [1,3]. …”

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confidence: 99%

Unusual and voluminous pulmonary trunk aneurysm

2011

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“…There are still many uncertainties regarding the natural prognosis of true idiopathic peripheral PAAs. Although there are currently no definitive guidelines on the management of this type of aneurysm, Deb et al reported that idiopathic PAAs are treated using the same hemodynamic forces as aortic aneurysms, and if cystic medial degeneration (CMD) is present, these aneurysms are prone to dissection and rupture [7]. It is recommended that patients with enlarged (> 6 cm) aneurysms that are central, as well as those of any size that are symptomatic, should receive treatment.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter Microcoil Embolization of an Idiopathic Solitary Pulmonary Artery Aneurysm

Iwamoto

Kinoshita

Miyamoto

et al. 2017

Interventional Radiology

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An incidental vascular abnormality was identified in a female patient in her 70s with a history of malignant lymphoma. Contrast-enhanced computed tomography (CT) scans revealed a pulmonary artery aneurysm (PAA) originating at the A10 branch of the right pulmonary artery (10 9 9 mm in size), which involved three distal branches at the aneurysmal sac. Retrospectively, this PAA was identified on CT images two years prior, and has been growing since. Endovascular embolization was performed with microcoils that were placed in the aneurysmal sac and the distal and proximal sites of the parent artery, achieving complete resolution of the PAA without complications. Coil embolization can be one of the treatment options in management of the unruptured PAA, although further investigations are necessary.

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“…[1] Almost half of the cases have accompanying congenital heart disease, the most common being patent ductus arteriosus. [3] Behçet's and Marfan syndromes, injuries, pulmonary hypertension, infections, and idiopathic factors are the other common underlying causes of these aneurysms. [3] The diagnosis should be based on TTE and cardiac catheterization findings to ascertain the extent of the aneurysm and rule out accompanying intracardiac pathologies.…”

Section: Discussionmentioning

confidence: 99%

“…[3] Behçet's and Marfan syndromes, injuries, pulmonary hypertension, infections, and idiopathic factors are the other common underlying causes of these aneurysms. [3] The diagnosis should be based on TTE and cardiac catheterization findings to ascertain the extent of the aneurysm and rule out accompanying intracardiac pathologies. [2,3] In addition, MRI is an essential diagnostic tool, as it is noninvasive and optimal for the detection of intimal flaps.…”

Section: Discussionmentioning

confidence: 99%