Wang Yue-Bo, Chen Guang-Wen, Pu Hong, Li Hang
Department of Radiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Qingyang District, Chengdu, 610072, Sichuan, China.
J Cardiothorac Surg. 2020 May 12;15(1):87. doi: 10.1186/s13019-020-01139-6.
Pulmonary artery aneurysm (PAA), usually associated with congenital heart disease (CHD), is a very rare clinical condition. Pulmonary artery dissection (PAD) is considered the most life-threatening complication of PAA, and patients can progress from being asymptomatic to sudden death. We report the following case of PAA associated with complicated congenital heart disease and simultaneous chronic PAD. To our knowledge, few such complicated cases have ever been reported.
A 36-year-old male presented to our hospital with a 10-year history of heart fatigue after activities and aggravated for 2 years. Computed tomography angiography (CTA) and echocardiogram showed a giant main pulmonary artery aneurysm (14 cm) with complicated congenital heart disease (a small patent ductus arteriosus, ventricular septal defects, aortic coarctation). Chronic PAD, which was mistaken for a pulmonary valve before operation, was detected during surgery.
PAA associated with complicated CHD and simultaneous PAD is very rare, and its clinical symptoms are varied. Radiologists and surgeons should pay attention to determining whether this patient simultaneously had PAD when PAA was detected on preoperative CTA imaging.
肺动脉瘤(PAA)通常与先天性心脏病(CHD)相关,是一种非常罕见的临床病症。肺动脉夹层(PAD)被认为是PAA最危及生命的并发症,患者可能从无症状发展为猝死。我们报告以下一例与复杂先天性心脏病相关且同时合并慢性PAD的PAA病例。据我们所知,很少有如此复杂的病例被报道过。
一名36岁男性因活动后心脏疲劳10年,加重2年就诊于我院。计算机断层扫描血管造影(CTA)和超声心动图显示一个巨大的主肺动脉瘤(14厘米),合并复杂先天性心脏病(小型动脉导管未闭、室间隔缺损、主动脉缩窄)。术中检测到慢性PAD,术前曾被误诊为肺动脉瓣。
与复杂CHD相关且同时合并PAD的PAA非常罕见,其临床症状多样。放射科医生和外科医生在术前CTA成像检测到PAA时,应注意判断该患者是否同时患有PAD。