Successful pulmonary valvuloplasty in combined pulmonary valve stenosis and selective left pulmonary artery ectasia

Abstract

A 57-year-old lady with effort dyspnea was admitted to our center for suspected pulmonary valve stenosis. The clinical history was remarkable for smoking and hypertension, whereas on physical examination a systolic murmur on the left subclavian space was clearly audible. Transesophageal echocardiography revealed a transpulmonary gradient of 60 mmHg and an enlargement of the left pulmonary artery. MRI detected an aneurysm of the left pulmonary artery with a normal right pulmonary artery: a selective eccentric jet from the valve to the left pulmonary artery was thought to be the cause of the left pulmonary artery enlargement (Fig. 1a). Angio-computed tomography confirmed a left pulmonary diameter of Images in cardiovascular medicine Fig. 1 Procedural diagnostic and interventional steps. (a) MRI: an eccentric jet from the valve selectively to the left pulmonary artery was apparent (arrow). (b) Angio-computed tomography of the heart and vessels: a severe dilatation a left pulmonary (43 mm) was demonstrated. (c) Three-dimensional reconstruction of computed tomography imaging. (d) Basal angiography of pulmonary trunk in lateral projection. (e) Pulmonary valve dilation by means of an 18 mm valvuloplasty balloon. (f) Final result on control angiography.