Akagi Satoshi, Ejiri Kentaro, Kasahara Shingo, Nakamura Kazufumi, Ito Hiroshi
1 Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan.
2 Department of Cardiovascular Surgery, Okayama University Hospital, Okayama, Japan.
Pulm Circ. 2019 Jan-Mar;9(1):2045894019831217. doi: 10.1177/2045894019831217.
Pulmonary artery aneurysms (PAA) can be complicated with pulmonary arterial hypertension (PAH), causing sudden death due to PA rupture and dissection. Because treatment with PAH-targeted drugs does not always prevent PAA progression, prophylactic surgical repair of the PAA seems a promising alternative. However, although it avoids rupture and dissection of the PAs, additional benefits have not been forthcoming. We therefore present two patients with co-existing PAH and a PAA who underwent surgical repair of the aneurysm. Following the surgery, their lung function and pulmonary hypertension improved. Optimal treatment of PAA remains uncertain, however, with no clear guidelines regarding the best therapeutic approach. This case series provides physicians with reasons to repair PAA surgically in patients with PAH.
肺动脉瘤(PAA)可并发肺动脉高压(PAH),导致因肺动脉破裂和夹层而猝死。由于使用PAH靶向药物治疗并不总能阻止PAA进展,因此对PAA进行预防性手术修复似乎是一种有前景的替代方法。然而,尽管它避免了肺动脉的破裂和夹层,但并未带来额外的益处。因此,我们介绍两名同时患有PAH和PAA并接受了动脉瘤手术修复的患者。手术后,他们的肺功能和肺动脉高压得到改善。然而,PAA的最佳治疗方法仍不确定,尚无关于最佳治疗方法的明确指南。本病例系列为医生提供了对PAH患者进行PAA手术修复的理由。