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Case Reports
. 2005;32(4):589-94.

Giant, dissecting, high-pressure pulmonary artery aneurysm: case report of a 1-year natural course

Anton Smalcelj  1 , Vojtjeh Brida, Miroslav Samarzija, Ante Matana, Eduard Margetic, Niksa Drinkovic
Affiliations
Case Reports

Giant, dissecting, high-pressure pulmonary artery aneurysm: case report of a 1-year natural course

Anton Smalcelj et al. Tex Heart Inst J. 2005.

Abstract

We report the rare subchronic clinical course of a giant, dissecting pulmonary artery aneurysm in an oligosymptomatic middle-aged woman who had idiopathic pulmonary hypertension. Diagnosis was simple with the use of echocardiography and multislice computed tomography. Conversely, deciding on the treatment was difficult, because prominent surgeons declined to perform surgical repair of the aneurysm and recommended heart-lung transplantation. Therefore, we were forced to treat our patient medically. She survived for 1 year, including 8 months of treatment with sildenafil, and then died suddenly while awaiting transplantation. Our patient, who had a dissecting, high-pressure pulmonary artery aneurysm, had an unexpectedly stable and uneventful clinical course for 1 year, which, under more favorable circumstances, might have provided enough time for heart-lung transplantation to be performed.

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Figures

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Fig. 1 Cross-sectional echocardiogram through the base of the heart, parasternal short-axis view. A giant pulmonary artery aneurysm (PAA) with a torn intimal flap (IF) is much larger in diameter than the ascending aorta (Ao). The main branches of the pulmonary artery, shown in the lower part of the figure, are also very wide.
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Fig. 2 Cross-sectional echocardiogram from an atypical left low parasternal (almost apical) acoustic window shows a large pulmonary artery aneurysm divided into 2 compartments by a torn intimal flap (IF). Color-flow Doppler echocardiography identified a true lumen (TL) and false lumen (FL). The left ventricle (LV) is quite small in comparison with the pulmonary artery aneurysm.
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Fig. 3 Echocardiogram from an atypical acoustic window (posterior view) shows the pulmonary artery aneurysm (PAA) through the pleural effusion (PE). Thrombotic mass (Thr) and torn intimal flaps (IF) are clearly visible.
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Fig. 4 Multislice computed tomographic scan provides a 3-dimensional reconstruction of a large pulmonary artery aneurysm (PAA) that dominates the thorax and covers the heart.
See this image and copyright information in PMC

References

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