Management of Pulmonary Artery Aneurysms in Pulmonary Hypertension: A Single-Center Review of 3 Cases

Abstract

Pulmonary artery aneurysms (PAAs) are defined as having pulmonary artery diameter of greater than 40 mm. PAAs are rare and can occur in various pulmonary diseases. There are no clear-cut guidelines regarding the management of PAAs, and recommendations for management are made based on expert consensus opinion, case reports, and institutional experience. This series highlights three patients with pulmonary hypertension (PH) and PAA. The clinical course and diagnostic findings and the decision-making involved in the treatment are reviewed. An overview of three distinct management strategies including medical management, heart/lung transplant, and surgical aneurysm repair is presented.

Massive Pulmonary Artery Aneurysm in a Patient with Ventricular Septal Defect: Case Report of a Rare Association

“…7,16 One-third of all PAAs reported may worsen due to rupture and die of massive hemoptysis, asphyxiation, exsanguination, and sudden death. 7,17 Treatment is surgical management in the presence of a shunt, or else conservative medical management. 18,19 Medical management includes calcium channel blockers, diuretics, anticoagulants, endothelin receptor antagonists, phosphodiesterase type 5 inhibitors, and prostacyclin derivatives.…”

“…18,19 Medical management includes calcium channel blockers, diuretics, anticoagulants, endothelin receptor antagonists, phosphodiesterase type 5 inhibitors, and prostacyclin derivatives. 17 A close monitoring and follow-up is warranted, to look for new or worsening symptoms, increase in size, thrombus in the PA, and for impending rupture or dissection. 15 Surgery is the cornerstone for treatment for PAA.…”

“…7, 16 One-third of all PAAs reported may worsen due to rupture and die of massive hemoptysis, asphyxiation, exsanguination, and sudden death. 7, 17…”

Management of Giant Pulmonary Artery Aneurysm with Quadricuspid Valve Stenosis

“…PAA aneurysms are usually asymptomatic, but without treatments the patients, especially those with a large PA diameter and growth rate > 2 mm/year, can develop fatal complications such as dissections, airways compressions, or coronary compressions leading to acute coronary syndromes. 3 4 The literature contains only a small number of reports about PAA treatment and there are no well-defined guidelines about its management. 5…”