A Rare Giant Pulmonary Aneurysm with Left Lung Compression: A Case Report with Insights from the Literature
DOI:
https://doi.org/10.1532/hsf.2343Abstract
Pulmonary artery aneurysm (PAA) is a rare condition that results from several pathologies. Here, we report a case of a rare giant PAA accompanied by left lung compression due to recurrent chest tightness for >13 years. Through this case and review of the literature, we explore the treatment options to improve the diagnosis and treatment of PAA. We found that patients with PAA may survive longer even if they also have pulmonary hypertension. In addition, it is recommended that if a PAA diameter is >5.5 cm or if the PAA diameter has increased by >0.5 cm in 6 months, the PAA should be operated on as soon as possible. Conservative treatment can be recommended in patients with congenital PAA if pulmonary arterial pressure is normal.
References
Araújo I, Escribano P, Lopez-Gude MJ, et al. 2011. Giant pulmonary artery aneurysm in a patient with vasoreactive pulmonary hypertension: a case report. BMC Cardiovasc Disord 11:64.
Baztarrica GP, Bevacqua F, Porcile R. 2010. Aneurisma de la arteria pulmonar = Pulmonary artery aneurysm. Rev Esp Cardiol 63(2):240-1. Spanish, English.
Brown JR, Plotnick G. 2008. Pulmonary artery aneurysm as a cause for chest pain in a patient with Noonan’s syndrome: a case report. Cardiology 110(4):249-51.
Butto F, Lucas RV Jr, Edwards JE. 1987. Pulmonary arterial aneurysm: a pathologic study of five cases. Chest 91:237-41.
Camargo J, Camargo SM, Machuca TN, Bello RM. 2010. Large pulmonary artery pseudoaneurysm due to lung carcinoma: pulmonary artery pseudoaneurysm. J Thorac Imaging 25(1):W4-5.
Caralps JM, Bonnin JO, Oter R, Aris A. 1978. True aneurysm of the main pulmonary artery: surgical correction. Ann Thorac Surg 25(6):561-3.
Chen YF, Chiu CC, Lee CS. 1996. Giant aneurysm of main pulmonary artery. Ann Thorac Surg 62(1):272-4.
Deb SJ, Zehr KJ, Shields RC. 2005. Idiopathic pulmonary artery aneurysm. Ann Thorac Surg 80(4):1500-2.
Deterling RA Jr, Clagett OT. 1947. Aneurysm of the pulmonary artery: review of the literature and report of a case. Am Heart J , 34(4):471-99.
Duijnhouwer AL, Navarese EP, Van Dijk AP, Loeys B, Roos-Hesselink JW, De Boer MJ. 2016. Aneurysm of the pulmonary artery, a systematic review and critical analysis of current literature. Congenit Heart Dis 11(2):102-9.
Ercan S, Dogan A, Altunbas G, Davutoglu V. 2014. Giant pulmonary artery aneurysm: 12 years of follow-up. Case report and review of the literature. Thorac Cardiovasc Surg 62(5):450-2.
Fakler U, Mebus S, Kaemmerer H, et al. 2008. A ticking time bomb--high pressure pulmonary artery aneurysm. Am J Med 121(9):777-80.
Fraser RS, Müller NL, Colman N, Paré PD. c1999. Fraser and Paré’s diagnosis of diseases of the chest. 4th ed. Philadelphia (PA): W.B. Saunders. Pulmonary hypertension and edema; p. 1935-7.
Fujiwara K, Naito Y, Higashiue S, et al. 1992. Left main coronary trunk compression by dilated main pulmonary artery in atrial septal defect. Report of three cases. J Thorac Cardiovasc Surg 104(2):449-52.
Galiè N, Saia F, Palazzini M, et al. 2017. Left main coronary artery compression in patients with pulmonary arterial hypertension and angina. J Am Coll Cardiol 69(23):2808-17.
Garcia A, Byrne JG, Bueno R, Flores RM. 2008. Aneurysm of the main pulmonary artery. Ann Thorac Cardiovasc Surg 14:399-401.
Hamawy AH, Cartledge RG, Girardi LN. 2002. Graft repair of a pulmonary artery aneurysm. Heart Surg Forum 5(4):396-8.
Imazio M, Cecchi E, Giammaria M, et al. 2004. Main pulmonary artery aneurysm: a case report and review of the literature. Ital Heart J 5(3):232-7.
Inayama Y, Nakatani Y, Kitamura H. 2001. Pulmonary artery dissection in patients without underlying pulmonary hypertension. Histopathology 38(5):435-42.
Iosifescu AG, Dorobanţu LF, Anca TM, Iliescu VA. 2012. Surgical treatment of a pulmonary artery aneurysm due to a regurgitant quadricuspid pulmonary valve. Interact Cardiovasc Thorac Surg 14(6):880-2.
Kim JK, Seol SH, Kim TJ, et al. 2013. Low pressure pulmonary artery aneurysm with atrial septal defect. J Cardiovasc Ultrasound 21(2):94-5.
Koch A, Mechtersheimer G, Tochtermann U, Karck M. 2010. Ruptured pseudoaneurysm of the pulmonary artery--rare manifestation of a primary pulmonary artery sarcoma. Interact Cardiovasc Thorac Surg 10(1):120-1.
Kreibich M, Siepe M, Kroll J, Höhn R, Grohmann J, Beyersdorf F. 2015. Aneurysms of the pulmonary artery. Circulation 131(3):310-6.
Lüchtrath H. 1981. Dissecting aneurysm of the pulmonary artery. Virchows Arch A Pathol Anat Histol 391(2):241-7.
Nguyen ET, Silva CI, Seely JM, Chong S, Lee KS, Müller NL. 2007. Pulmonary artery aneurysms and pseudoaneurysms in adults: findings at CT and radiography. AJR Am J Roentgenol 188(2):W126-34.
Reisenauer JS, Said SM, Schaff HV, Connolly HM, Maleszewski JJ, Dearani JA. 2017. Outcome of surgical repair of pulmonary artery aneurysms: a single-center experience with 38 patients. Ann Thorac Surg 104(5):1605-10.
Sargur R, Sudarshana Murthy KA. 2014. Pulmonary artery aneurysm - report of a case and review of literature. J Cardiovasc Med Cardiol 2(1):29-31.
Seguchi M, Wada H, Sakakura K, et al. 2011. Idiopathic pulmonary artery aneurysm. Circulation 124(14):e369-70.
Shankarappa RK, Moorthy N, Chandrasekaran D, Nanjappa MC. 2010. Giant pulmonary artery aneurysm secondary to primary pulmonary hypertension. Tex Heart Inst J 37(2):244-5.
Shih HH, Kang PL, Lin CY, Lin YH. 2007. Main pulmonary artery aneurysm. J Chin Med Assoc 70(10):453-5.
Smalcelj A, Brida V, Samarzija M, Matana A, Margetic E, Drinkovic N. 2005. Giant, dissecting, high-pressure pulmonary artery aneurysm: case report of a 1-year natural course. Tex Heart Inst J 32(4):589-94.
Tami LF, McElderry MW. 1994. Pulmonary artery aneurysm due to severe congenital pulmonic stenosis: case report and literature review. Angiology 45(5):383-90.
Theodoropoulos P, Ziganshin BA, Tranquilli M, Elefteriades JA. 2013. Pulmonary artery aneurysms: four case reports and literature review. Int J Angiol 22(3):143-8.
Truong QA, Massaro JM, Rogers IS, et al. 2010. Age and gender-specific pulmonary artery measurements by multi-detector computed tomography: Framingham Heart Study. J Am Coll Cardiol 55(10 suppl):A71.E665.
Tsui EY, Cheung YK, Chow L, Chau LF, Yu SK, Chan JH. 2001. Idiopathic pulmonary artery aneurysm: digital subtraction pulmonary angiography grossly underestimates the size of the aneurysm. Clin Imaging 25(3):178-80.
Veldtman GR, Dearani JA, Warnes CA. 2003. Low pressure giant pulmonary artery aneurysms in the adult: natural history and management strategies. Heart 89(9):1067-70.
Vural AH, Türk T, Ata Y, Göncü T, Ozyazicioglu A. 2007. Idiopathic asymptomatic main pulmonary artery aneurysm: surgery or conservative management? A case report. Heart Surg Forum 10(4):E273-5.
Żyłkowska J, Kurzyna M, Florczyk M, et al. 2012. Pulmonary artery dilatation correlates with the risk of unexpected death in chronic arterial or thromboembolic pulmonary hypertension. Chest 142(6):1406-16.
