Graft Repair of a Pulmonary Artery Aneurysm

Abstract

Aneurysm of the main pulmonary artery is a rare anomaly with a poorly understood pathogenesis. We report the suc-cessful surgical resection and repair of a pulmonary artery aneurysm using aneurysmectomy and replacement of the pul-monary artery with Dacron, a procedure with excellent long-term outcome that eliminates the risk of recurrence. The 65-year-old male patient presented with a marked decrease in exercise tolerance and worsening dyspnea. He had a history of pulmonary stenosis diagnosed during childhood, episodic shortness of breath beginning during his teenage years, hypertension, and smoking. On physical examination, the patient appeared generally well. Computed tomographic scan of the chest revealed an 8-cm aneurysm involving the main pulmonary artery and pulmonary artery bifurcation. Coro-nary angiography showed a massive aneurysm of the main and left pulmonary arteries, with mild dilation of the proxi-mal right pulmonary artery. Surgery was performed through a median sternotomy with the use of normothermic, bicaval cardiopulmonary bypass. The aneurysm of the main pul-monary artery and dilated bifurcation of the pulmonary artery was excised and reconstruction was performed using a 22-mm Dacron graft. The patient’s postoperative course was uneventful. He was discharged to home on postoperative day 5 and was well at 1-month follow-up.