Successful Surgical Repair of Pulmonary Artery Aneurysm and Regurgitation

Abstract

Pulmonary artery aneurysm (PAA) is generally a rare lesion, and there is no definitive approach for it. We report the case of a 45-year-old man who was admitted for the evaluation of dyspnea. In childhood, he had been diagnosed with PAA with congenital pulmonary valve stenosis and regurgitation, and he had a percutaneous transvenous pulmonary valve commissurotomy. Transthoracic echocardiogram showed dilatation of the right atrium and right ventricle, with right ventricular hypertrophy. There was severe pulmonary valve regurgitation, and the main pulmonary artery was dilated to 68 mm in diameter. From the surgical findings, the left leaflet of pulmonary valve was torn from commissure with failure to coapt with the other leaflet. After direct sutures of edges of the left leaflet, a nearly normal valvular competence was restored. The PAA was repaired with a Y-shaped 24 × 12 mm Dacron graft replacement. The postoperative course was uneventful, and the patient was discharged.

Succesfull management of a giant pulmonary artery aneurysm associated with severe congenital pulmonary valve stenosis in an adult patient

“…Pulmonary artery aneurysms (PAA) represent a dilation of the main pulmonary artery of more than 40mm 1 . They are very rare entities; studies show a prevalence of 0.007% with 89% in the pulmonary artery trunk 2 . Cases have been described mostly in association with congenital defects like left to right shunts (ventricular/atrial septal defects, persistent ductus arteriosus) but also with pulmonary valve stenosis, regurgitation or absence 1,3 .…”

Use of a Three-Dimensional Model in Lung Transplantation for a Patient With Giant Pulmonary Aneurysm

“…Surgical management of aneurysms of the main PA trunk in the setting of cadaveric donor lung transplantation included a replacement of the aneurysm with a donor's aorta and PA trunk [2][3][4][5] in addition to an artificial prosthesis. 6 These were associated with favorable outcomes; however, the optimal graft for each patient depends on their particular aneurysm. For our patient, we created a plastic three-dimensional (3D) model of the PA aneurysm, which allowed us to simulate the procedure preoperatively and intraoperatively, and to successfully replace the PA aneurysm with the donor's aorta.…”