Perioperative Management of a Large Idiopathic Pulmonary Artery Aneurysm Without Pulmonary Arterial Hypertension

Pulmonary Artery Aneurysm Associated With Severe Pulmonary Hypertension in a Patient Presenting for Double Lung Transplant: Review of a Rare Disorder and Role of Transesophageal Echocardiography

“…4 In certain cases, main PAAs can be short in length and can indistinctly merge into a right and left PAA, making discrete maximum PA diameter measurement difficult. 5 However, every effort should be made to measure the maximum diameter of the aneurysmal sac to document the rate of growth of the PAA, as progression of the size of the aneurysm has been shown to increase surgical risk. 1 Majority of PAAs (more than 80%) occur in the main PA. 2 Per Hou et al, aneurysms involving the left PA were more common than those of the right PA, because of its straighter anatomical orientation.…”

“…Laplace's law states that wall stress is directly proportional to pressure and radius of the vessel wall and inversely proportional to the wall thickness. Any congenital or acquired condition that causes an elevation in PA pressures can lead to aneurysmal dilation of the PA. 5 For this reason, it is not uncommon for PAA to be associated with high PA pressures. PAA can, however, be associated with low or very mildly elevated pulmonary arterial pressures.…”

Giant pulmonary artery aneurysms

“…Lastly, topicalization of airway with lidocaine and/or use of intravenous remifentanil infusion during emergence from anesthesia, may help mitigate coughing and stent displacement. (1)(2)(3)…”

“…Additionally, tracheobronchomalacia can occur resulting in dynamic airflow obstruction. (1,2) Diagnosis is often established with radiological imaging. Ventilation perfusion mismatch from lung collapse in patients with giant aneurysms can worsen cyanosis and hypoxemia related to pre-existing pulmonary arterial hypertension.…”

Transcatheter embolization for idiopathic peripheral pulmonary arterial aneurysm: A case report

“…PAAs are classified according to causes as congenital, acquired, and idiopathic . Idiopathic PAAs are rare; however, several cases have been reported . Greene and Baldwin have proposed four pathological criteria for diagnosing an idiopathic PAA: simple dilatation of the pulmonary trunk with or without involvement of the rest of the arterial tree, the absence of intracardiac or extracardiac shunts, the absence of chronic cardiac or pulmonary disease, and the absence of arterial disease such as syphilis or more than minimal atheromatosis or arteriosclerosis of the pulmonary vascular tree .…”