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一名成年患者罕见地出现左肺动脉缺如,并伴有室间隔缺损、肺动脉高压,更有趣的是还伴有动脉导管未闭:病例报告及文献综述

A rare association of the absence of left pulmonary artery with ventricular septal defect, pulmonary hypertension, and more interestingly, patent ductus arteriosus in an adult patient: Case report and literature review.

作者信息

Parsaee Mozhgan, Saedi Sedigheh, Behrooj Soudabeh, Emami Elaheh, Salehi Pegah, Mohammadzadeh Ali

机构信息

Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center Iran University of Medical Sciences Tehran Iran.

Rajaie Cardiovascular Medical and Research Center Iran University of Medical Sciences Tehran Iran.

出版信息

Clin Case Rep. 2024 Jul 9;12(7):e9138. doi: 10.1002/ccr3.9138. eCollection 2024 Jul.

DOI:10.1002/ccr3.9138
PMID:38988892
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11233255/
Abstract

KEY CLINICAL MESSAGE

In this study, we introduced one of the rarest concomitants of the absence of left pulmonary artery (LPA), which was seen in our patient along with patent ductus arteriosus (PDA) and ventricular septal defect (VSD).

ABSTRACT

Unilateral absence of pulmonary artery (UAPA) is a congenital heart disease in association with other abnormalities such as tetralogy of Fallot and septal defects or isolated in 30% of cases and occurs in the right lung in two thirds of cases. Our case is a 33-year-old man who was hospitalized with symptoms of cough, shortness of breath, and hemoptysis. The echocardiography revealed a large ventricular septal defect, absent left pulmonary artery, and severe pulmonary hypertension (PH) along with patent ductus arteriosus. These findings were confirmed by CT angiography. This association has rarely been found in past studies. Due to PH and pulmonary infection, the patient was treated with intravenous prostaglandin and antibiotics. However, in cases of timely diagnosis and treatment of UAPA, fatal complications such as pulmonary hypertension, morbidity, and mortality are reduced. This case emphasizes the importance of awareness of this abnormality and its associated anomalies to enable early diagnosis and treatment.

摘要

关键临床信息

在本研究中,我们介绍了左肺动脉缺如这种极为罕见的伴随情况,我们的患者同时存在动脉导管未闭(PDA)和室间隔缺损(VSD)。

摘要

单侧肺动脉缺如(UAPA)是一种先天性心脏病,常与其他异常情况如法洛四联症和间隔缺损相关,或在30%的病例中单独出现,三分之二的病例发生在右肺。我们的病例是一名33岁男性,因咳嗽、气短和咯血症状入院。超声心动图显示巨大室间隔缺损、左肺动脉缺如、严重肺动脉高压(PH)以及动脉导管未闭。CT血管造影证实了这些发现。过去的研究中很少发现这种关联。由于肺动脉高压和肺部感染,患者接受了静脉注射前列腺素和抗生素治疗。然而,对于UAPA病例,及时诊断和治疗可减少诸如肺动脉高压、发病率和死亡率等致命并发症。本病例强调了认识这种异常及其相关异常以实现早期诊断和治疗的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02f6/11233255/7e1b145aa73b/CCR3-12-e9138-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02f6/11233255/74609e68719e/CCR3-12-e9138-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02f6/11233255/4d6907770052/CCR3-12-e9138-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02f6/11233255/a4e87835d086/CCR3-12-e9138-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02f6/11233255/7e1b145aa73b/CCR3-12-e9138-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02f6/11233255/74609e68719e/CCR3-12-e9138-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02f6/11233255/4d6907770052/CCR3-12-e9138-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02f6/11233255/a4e87835d086/CCR3-12-e9138-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02f6/11233255/7e1b145aa73b/CCR3-12-e9138-g001.jpg

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本文引用的文献

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Isolated unilateral absence of pulmonary artery in adulthood: a clinical analysis of 65 cases from a case series and systematic review.成人孤立性单侧肺动脉缺如:来自病例系列研究及系统评价的65例临床分析
J Thorac Dis. 2017 Dec;9(12):4988-4996. doi: 10.21037/jtd.2017.11.49.
2
Unilateral absence of pulmonary artery: pathophysiology, symptoms, diagnosis and current treatment.单侧肺动脉缺如:病理生理学、症状、诊断和当前治疗。
Arch Cardiovasc Dis. 2013 Aug-Sep;106(8-9):448-54. doi: 10.1016/j.acvd.2013.05.004. Epub 2013 Aug 9.
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Absence of Left Pulmonary Artery: Case report.
左肺动脉缺如:病例报告。
Sultan Qaboos Univ Med J. 2009 Aug;9(2):180-3. Epub 2009 Jun 30.
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Congenital isolated unilateral absence of pulmonary artery and variants of collateral blood supply of the ipsilateral lung.先天性孤立性单侧肺动脉缺如及同侧肺侧支血供变异
Interact Cardiovasc Thorac Surg. 2011 Mar;12(3):509-10. doi: 10.1510/icvts.2010.250795A.
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Age-related clinical characteristics of isolated congenital unilateral absence of a pulmonary artery.孤立性先天性单侧肺动脉缺如的年龄相关临床特征
Pediatr Cardiol. 2010 Nov;31(8):1186-90. doi: 10.1007/s00246-010-9787-5. Epub 2010 Sep 3.
6
A 50-year-old woman with dyspnea, lower extremity edema, and volume loss of the right hemithorax.一名50岁女性,有呼吸困难、下肢水肿及右半侧胸腔容积减少症状。
Chest. 2009 Aug;136(2):628-632. doi: 10.1378/chest.09-0080.
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Imaging features of isolated unilateral pulmonary artery agenesis presenting in adulthood: a review of four cases.成人孤立性单侧肺动脉发育不全的影像学特征:4例病例回顾
Clin Radiol. 2007 Mar;62(3):238-44. doi: 10.1016/j.crad.2006.10.006.
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Isolated unilateral absence of right proximal pulmonary artery: surgical repair and follow-up.孤立性右侧近端肺动脉缺如:手术修复及随访
Ann Thorac Surg. 2005 Apr;79(4):1399-402. doi: 10.1016/j.athoracsur.2003.10.037.
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The remarkable right ventricle of patients with Eisenmenger syndrome.艾森曼格综合征患者显著增大的右心室。
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