Abstract
BackgroundIdiopathic pulmonary artery aneurysm is a rare anomaly with only a handful reports in the literature. It is often asymptomatic, while the first presentation could be severe hemoptysis or death.Surgical intervention needs to be planned carefully with a multidisciplinary team approach to secure optimal outcome. We hope to spread our experience with such cases and to encourage other surgeons worldwide to deal surgically with these cases when its indicated.Case presentationA 47 years old man presented to our institution after three episodes of hemoptysis, echo demonstrated good left ventricle (LV) systolic function, normal right ventricle (RV) size and function, Chest computed tomography (CT) revealed aneurysmal dilatation with pending rupture of the pulmonary artery trunk (4.5 cm), the left pulmonary artery (6 cm) and the right pulmonary artery (2.3 cm). The patient successfully underwent replacement of Pulmonary artery trunk, left pulmonary artery and right pulmonary artery by Wovex Prosthetic graft (28 mm). The patient discharged home on the eight postoperative day in good clinical condition .ConclusionWith this case report we wish to emphasize the need for a careful multidisciplinary approach given the complex and rare nature of the reported pathology.
Highlights
Idiopathic pulmonary artery aneurysm is a rare anomaly with only a handful reports in the literature
The etiology and pathogenesis have never been clarified completely.Varied clinical presentations of pulmonary artery aneurysm have been reported, though often it is asymptomatic while the first presentation could be hemoptysis or death
Our patient fit into the diagnosis of idiopathic pulmonary artery aneurysm, and he fulfilled the standard criteria [3]: Fig. 2 3D - Chest computed tomography angiogram scan (CT) showing: Hugely dilated pulmonary trunk compressing the adjacent Aorta there was involvement of the pulmonary artery, absence of abnormal cardiac or extra-cardiac shunts and absence of cardiac or pulmonary disease
Summary
Aneurysms of the pulmonary artery are a very rare clinical entity with only a handful reported worldwide. A transthoracic echocardiography showed normal LV systolic function with ejection fraction of 60%, no valve lesion, normal RV size and function and no pulmonary hypertension (PHT) (Additional file 1: Video). Cardiac catheterization showed normal coronaries with no signs of compression by the adjacent pulmonary artery aneurysms (PAAs). The main, intraparanchymal left pulmonary artery deep in the left hilum and origin of right pulmonary arteries were fully dissected. They were very frail and even translucent to blood. During regular followup and after one year from surgery the transthoracic echo was performed and demonstrated normal RV size and function, no valve lesion, normal LV systolic function with ejection fraction 60% and no PHT (Additional file 1: Video)
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