Successful beating‐heart repair of pulmonary artery dissection using a composite valve‐tube graft

Abstract

Pulmonary artery dissection is rare but highly lethal. Recent reports suggest that surgical repair of pulmonary artery dissection may yield good outcomes in selected patients, although postoperative right ventricular failure and death have been described. Currently, only one patient over age 60 years old has been reported to survive open surgical repair of pulmonary artery dissection. Here, we present the case of a sexagenarian with pulmonary artery hypertension complicated by a dissected pulmonary artery aneurysm which was successfully repaired using a composite valve‐tube graft under a beating‐heart strategy.

Surgical Repair of Giant Dissecting Pulmonary Artery Aneurysm Associated with Atrial Septal Defect and Pulmonary Arterial Hypertension: A Case Report

“…These include surgical correction, conservative treatment, heart-lung transplantation, or surgical repair with lung transplantation (LTx), as shown in Table 2 (Ref. [2,[9][10][11][12][13][14][15][16][17][18][19][20][21]). Some studies have also proposed the use of endovascular repair, which is more applicable for acute iatrogenic injury [22] and special cases without aneurysmal dilatation of the pulmonary trunk [23] not suitable for this case.…”

“…It is crucial to determine the optimal timing and condition of surgery for each patient [28]. Aneurysmectomy with homograft replacement is a common surgical procedure that usually results in a favorable outcome [9,[12][13][14][15]. For the consideration of PV replacement, patients with main PAA and PAH who often have significant PR, concurrent PV replacement should be considered during the operation, even if the valve leaflets are not involved in the dissection, to prevent long-term recurrence caused by abnormal hemodynamics [29].…”