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成人先天性孤立性单侧肺动脉发育不全:病例系列报道及文献复习

Congenital isolated unilateral agenesis of pulmonary arteries in adults: case series and review.

作者信息

Jariwala Pankaj, Maturu Venkata Nagarjuna, Christopher Johann, Jadhav Kartik Pandurang

机构信息

Department of Cardiology, Yashoda Hospitals, Somajiguda, Raj Bhavan Road, Hyderabad, 500082 India.

Department of Pulmonology, Yashoda Hospitals, Somajiguda, Raj Bhavan Road, Hyderabad, 500082 India.

出版信息

Indian J Thorac Cardiovasc Surg. 2021 Jan;37(Suppl 1):144-154. doi: 10.1007/s12055-020-01032-w. Epub 2020 Sep 23.

Abstract

Congenital, isolated unilateral agenesis of pulmonary arteries (UAPA) has a bimodal clinical presentation. It is either diagnosed in early infancy or during adulthood. Early diagnosis and timely surgical correction at infancy prevent the development of irreversible pulmonary hypertension and enable prolonged survival. Though surgical intervention is a conclusive method of treatment, its outcome depends upon the reversibility of pulmonary hypertension and the adequacy of the pulmonary artery dimension. Adults with UAPA can be asymptomatic (diagnosed incidentally) or symptomatic. They may present clinically with myriads of symptoms like exertional dyspnea, recurrent lung infection, hemoptysis, and atypical chest pain. For cases where definitive surgical treatment is not feasible, interventional and medical management should be carried out as part of palliative therapy. A retrospective analysis of 22 cases of UAPA in adults published in the literature from the years 2017-2020 are presented here, along with our institutional case.

摘要

先天性孤立性单侧肺动脉发育不全(UAPA)具有双峰临床表现。它要么在婴儿早期被诊断出来,要么在成年期被诊断出来。婴儿期的早期诊断和及时手术矫正可预防不可逆性肺动脉高压的发展,并能延长生存期。虽然手术干预是一种确定性的治疗方法,但其结果取决于肺动脉高压的可逆性和肺动脉尺寸是否足够。患有UAPA的成年人可能无症状(偶然诊断)或有症状。他们临床上可能出现多种症状,如劳力性呼吸困难、反复肺部感染、咯血和非典型胸痛。对于无法进行确定性手术治疗的病例,应作为姑息治疗的一部分进行介入和药物治疗。本文介绍了对2017年至2020年文献中发表的22例成人UAPA病例的回顾性分析,以及我们机构的病例。

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