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一名患有严重二尖瓣和主动脉瓣疾病的患者因2型肺动脉高压导致肺动脉瘤——综述及病例报告

Pulmonary artery aneurysm as a result of group 2 pulmonary artery hypertension in a patient with significant mitral and aortic valve disease - review and case report.

作者信息

Marzec Karolina, Jaworska-Wilczyńska Maria, Grobelny Konrad, Kołsut Piotr, Michałowska Ilona, Stokłosa Patrycjusz, Hryniewiecki Tomasz

机构信息

Department of Acquired Cardiac Defects, National Institute of Cardiology, Warsaw, Poland.

Department of Cardiac Surgery and Transplantology, National Institute of Cardiology, Warsaw, Poland.

出版信息

Kardiochir Torakochirurgia Pol. 2020 Sep;17(3):143-148. doi: 10.5114/kitp.2020.99078. Epub 2020 Sep 23.

Abstract

Aneurysms are uncommon, but potentially life-threatening abnormalities of the pulmonary arteries. Aneurysm of the main pulmonary artery (MPA) defined as MPA diameter over 40 mm was reported in 1 : 14 000 autopsies. The most frequent location is the main pulmonary artery (89% of cases), whereas the maximum described diameter is 106-170 mm. Clinical manifestations are usually nonspecific or asymptomatic. Right heart failure symptoms, pulmonary regurgitation, trachea or bronchi compression or pulmonary emboli caused by enlarged MPA are the most commonly described clinical manifestations. Pulmonary artery aneurysm dissection is an uncommon complication but associated with a high mortality rate. Unfortunately, guidelines regulating the optimal time for the surgical intervention still have not been developed. We present the history of 76-year-old patient suffering from an aneurysm of the pulmonary artery (74 × 61 mm), as well as mitral and aortic valve disease, who was successfully operated on in our hospital.

摘要

肺动脉瘤并不常见,但可能危及生命。据报道,在14000例尸检中,主肺动脉(MPA)直径超过40mm的主肺动脉瘤发生率为1:14000。最常见的部位是主肺动脉(89%的病例),而报道的最大直径为106 - 170mm。临床表现通常不具特异性或无症状。右心衰竭症状、肺动脉反流、气管或支气管受压或主肺动脉扩大导致的肺栓塞是最常描述的临床表现。肺动脉瘤夹层是一种罕见的并发症,但死亡率很高。遗憾的是,目前仍未制定出规范手术干预最佳时机的指南。我们介绍了一名76岁患有肺动脉瘤(74×61mm)以及二尖瓣和主动脉瓣疾病的患者的病史,该患者在我院成功接受了手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50cd/7526489/44930a3477be/KITP-17-41811-g001.jpg

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