Department of Pediatrics, Johns Hopkins All Children's Hospital, Saint Petersburg, Florida.
Division of Pediatric Cardiology, Johns Hopkins All Children's Hospital, Saint Petersburg, Florida.
Catheter Cardiovasc Interv. 2019 Jun 1;93(7):1336-1339. doi: 10.1002/ccd.28292. Epub 2019 Apr 29.
Pulmonary artery aneurysm (PAA) and pulmonary artery pseudoaneurysm (PAP) are rare diagnoses in the pediatric population and carry a high risk of mortality if rupture occurs. There is currently no standard therapeutic approach to PAAs and PAPs. Reports of surgical intervention describe high mortality. We present a case of an infant with a PAP that was successfully treated with a percutaneous device closure. Our approach included deployment of a 6-mm Amplatzer Vascular Plug 2 (Abbott, St. Paul, MN) in the right lower pulmonary artery segmental branch just proximal to the origin of the pseudoaneurysm. Subsequent imaging 1-month post-procedure demonstrated a >50% reduction in the size of the PAP when compared to original imaging studies and near-complete resolution 14 months following the intervention. Percutaneous device placement to occlude the vessel supplying peripheral PAAs and PAPs may be a reasonable alternative to open surgical resection when treating patients with this rare, but potentially life-threatening vascular anomaly. To our knowledge, this is the first case describing a successful device closure of a PAP in an infant weighing <3 kg.
肺动脉瘤(PAA)和肺动脉假性动脉瘤(PAP)在儿科中罕见诊断,如果发生破裂,死亡率很高。目前对于 PAA 和 PAP 没有标准的治疗方法。手术干预的报告描述了高死亡率。我们报告了一例婴儿 PAP 的病例,该病例通过经皮器械封堵成功治疗。我们的方法包括在右肺下动脉节段性分支中,在假性动脉瘤起源的近端,放置一个 6 毫米的 Amplatzer 血管塞 2(雅培,明尼苏达州圣保罗)。术后 1 个月的影像学检查显示,与原始影像学研究相比,PAP 的大小减少了>50%,且在介入治疗后 14 个月基本完全消退。当治疗患有这种罕见但可能危及生命的血管异常的患者时,经皮器械放置以闭塞供应外周 PAA 和 PAP 的血管可能是开放性手术切除的合理替代方法。据我们所知,这是首例描述在体重<3kg 的婴儿中成功封堵 PAP 的病例。