Pulmonary Artery Aneurysm: A Rarity and Surgical Enigma

Abstract

Given the low incidence of pulmonary artery aneurysms (PAAs), proven surgical indications do not yet exist. We present a patient with a 6.3 cm PAA who underwent an open sternotomy, pulmonary artery aneurysmectomy, and repair with an aortic homograft. We discuss surgical indications, including pain, growth in diameter, and diameter of 5.5 cm and larger. The current recommended surgical indication for the size of PAAs is based on recommendations for aortic aneurysms and observation in a small number of operable patients, highlighting the need for more discussion and reporting of this rare presentation.

Pulmonary artery aneurysm protruding into the bronchus as an endobronchial mass: A case report

“…PA aneurysms may also occur secondary to pulmonary hypertension, autoimmune diseases or vasculitis. Finally, PA aneurysms with no clear cause were considered idiopathic[ 4 - 6 ]. Generally, PA aneurysms are less often clinically evident and are usually diagnosed based on chest radiographs or at autopsies[ 7 ].…”

“…Spontaneous PA aneurysm rupture is rare but is, when it occurs, often a catastrophic complication of massive hemoptysis. Most PA aneurysms appear to rupture into the alveolar parenchyma and do not impinge directly on the bronchus, and they are rarely detected by bronchoscopy[ 4 ]. Here, we report a rare condition in which a PA aneurysm protruded into the bronchus as an endobronchial mass that blocked the airway lumen, providing clinical implications for the differential diagnosis and management of endobronchial lesions.…”

Case Report: Surgical management of idiopathic pulmonary aneurysms and review surgical approaches

“…For patients with appropriate or normal vessel wall thickness, direct removal of the pulmonary aneurysm can be performed. However, for patients with very thin pulmonary arteries, it is recommended to use artificial vascular grafts, along with wrapping using the patient's blood vessels (11)(12)(13). Subsequently, the involvement of both the right and left pulmonary arteries must be taken into consideration.…”