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症状性特发性肺动脉瘤:一例病例报告及文献综述

Symptomatic idiopathic pulmonary artery aneurysm: a case report and a mini-review of the literature.

作者信息

Merrin Caitlin, Chan Swe Nyein, Degheim George

机构信息

Department of Cardiology, HCA Healthcare/USF Morsani College of Medicine, HCA Florida Northside Hospital Saint Petersburg, Florida, USA.

出版信息

Am J Cardiovasc Dis. 2024 Aug 25;14(4):230-235. doi: 10.62347/DBOS5122. eCollection 2024.

Abstract

Pulmonary artery aneurysms (PAAs) are rare, more prevalent in younger population with equal sex incidence. Congenital, idiopathic, autoimmune, infectious, inflammatory, and malignant etiologies have been linked to PAAs. Commonly, patients with PAA are asymptomatic, even those with large PAAs. Presenting symptoms, if any, are non-specific. The management should target the underlying conditions and serial imaging follow-up. Signs and symptoms of disease progression should prompt a change in treatment strategy. Though there is no consensus, those who are symptomatic with a PAA diameter > 5 cm generally should undergo surgical repair. More recently, endovascular interventions are available for certain PAAs. We present a 78-year-old female who was referred to the cardiology clinic for cough and dyspnea. Using computed tomography (CTA) of the chest, she was diagnosed with aneurysm of the main pulmonary artery (PA), without involvement of distal pulmonary arteries or thoracic aorta. She underwent repair of the pulmonary artery using a 34-mm tubular graft with a complete resolution of her symptoms.

摘要

肺动脉瘤(PAAs)较为罕见,在年轻人群中更为常见,男女发病率相等。先天性、特发性、自身免疫性、感染性、炎症性和恶性病因均与肺动脉瘤有关。通常情况下,肺动脉瘤患者没有症状,即使是那些患有大动脉瘤的患者也是如此。如果有症状,表现也不具有特异性。治疗应针对潜在病因并进行系列影像学随访。疾病进展的体征和症状应促使治疗策略的改变。尽管尚无共识,但对于直径>5 cm且有症状的肺动脉瘤患者,一般应接受手术修复。最近,某些肺动脉瘤可采用血管内介入治疗。我们报告一位78岁女性,因咳嗽和呼吸困难转诊至心脏病诊所。通过胸部计算机断层扫描(CTA),她被诊断为主肺动脉(PA)瘤,远端肺动脉或胸主动脉未受累。她接受了使用34毫米管状移植物的肺动脉修复术,症状完全缓解。

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本文引用的文献

1
Pulmonary artery aneurysm: a review.肺动脉瘤:综述
Pulm Circ. 2020 Feb 28;10(1):2045894020908780. doi: 10.1177/2045894020908780. eCollection 2020 Jan-Mar.
2
Pulmonary artery aneurysms: diagnosis & endovascular therapy.肺动脉瘤:诊断与血管内治疗
Cardiovasc Diagn Ther. 2018 Jun;8(3):350-361. doi: 10.21037/cdt.2018.04.01.
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Idiopathic dilatation of pulmonary artery: A review.特发性肺动脉扩张:综述
Indian Heart J. 2017 Jan-Feb;69(1):119-124. doi: 10.1016/j.ihj.2016.07.009. Epub 2016 Jul 15.
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Aneurysms of the pulmonary artery.肺动脉瘤
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Aneurysms and pseudoaneurysms of the pulmonary vasculature.肺血管的动脉瘤和假性动脉瘤。
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