Journal Information
Vol. 57. Issue 8.
Pages 541 (August 2021)
Vol. 57. Issue 8.
Pages 541 (August 2021)
Clinical Image
Full text access
Giant pulmonary artery aneurysm in pulmonary arterial hypertension
Aneurisma gigante de la arteria pulmonar en hipertensión arterial pulmonar
Visits
...
Pedro Caravaca Pereza,b,
Corresponding author
pecarav86@gmail.com

Corresponding author.
, Agueda Aurtenetxe Pereza, Pilar Escribano Subiasa,b
a Fundación Investigación i+12, Unidad Multidisciplinar Hipertensión Pulmonar, Servicio Cardiología, Hospital Universitario 12 Octubre, Madrid, Spain
b CIBER en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
Article information
Full Text
Bibliography
Download PDF
Statistics
Figures (1)
Full Text

Our patient was a 68-year-old woman, diagnosed with idiopathic pulmonary hypertension (PH) 15 years previously, treated with triple vasodilator therapy and considered high risk, given the following hemodynamic parameters: mean pulmonary artery pressure 52 mmHg, cardiac index 2.15 l/min/m2, right atrial pressure 11 mmHg, pulmonary vascular resistance 11 Wood units. Chest X-ray (Fig. 1A) revealed a prominent pulmonary artery and echocardiogram (Figs. 1B and C) showed a dilated right ventricle with mild dysfunction and dilated pulmonary artery. A CT angiogram of the pulmonary arteries performed during follow-up showed aneurysmal dilatation of the pulmonary trunk and main branches with a maximum diameter of 103 mm (Fig. 1D), producing partial compression of the pulmonary bronchial tree (arrow Fig. 1D) that caused repeated respiratory infections. She presented exertional angina, and coronary angiography showed tapering of the left coronary artery (LCA) due to extrinsic compression (arrow Fig. 1F), resolved with implantation of a drug-eluting stent (Fig. 1 G; arrow in Fig. 1E).

Figure 1.

A: chest X-ray, posteroanterior projection. B: transthoracic echocardiography, apical 4 chamber view. C: transthoracic echocardiography, short axis parasternal plane at the level of the large vessels. D–E: chest computed tomography with contrast medium, mediastinal window. F–G: coronary angiography, anteroposterior projection.

AP: pulmonary artery; VD: right ventricle; VI: left ventricle; AD: right atrium; AI: left atrium; Ao: Aorta; APD: right pulmonary artery.

(0.27MB).

Pulmonary artery aneurysms are a frequent complication in PH, with a prevalence of up to 40%.1 They are associated with the severity of the hemodynamic situation and time of progression. Potential complications include extrinsic compression of the LCA,2 thrombosis, and wall dissection.3

Our clinical case is one of the largest pulmonary aneurysms published in the literature and illustrates the main associated complications.

Funding

This study was funded by the Instituto de Salud Carlos III (Ministry of Economy, Industry and Competitiveness) and co-funded by the European Regional Development Fund via the CIBER cardiovascular diseases network (CB16/11/00502).

References
[1]
J. Nuche, J.M. Montero Cabezas, C. Jiménez López-Guarch.
Frequency, predictors and prognostic impact of pulmonary artery aneurysms in patients with pulmonary arterial hypertension.
Am J Cardiol, 123 (2019), pp. 474-481
[2]
N. Galiè, F. Saia, M. Palazzini.
Left main coronary artery compression in patients with pulmonary arterial hypertension and angina.
J Am Coll Cardiol, 69 (2017), pp. 2808-2817
[3]
J. Zyłkowska, M. Kurzyna, M. Florczyk.
Pulmonary artery dilatation correlates with the risk of unexpected death in chronic arterial or thromboembolic pulmonary hypertension.
Chest, 142 (2012), pp. 1406-1416

Please cite this article as: Caravaca Perez P, Aurtenetxe Perez A, Escribano Subias P. Aneurisma gigante de la arteria pulmonar en hipertensión arterial pulmonar. Arch Bronconeumol. 2021;57:541.

Copyright © 2020. SEPAR
Archivos de Bronconeumología

Subscribe to our newsletter

Article options
Tools

Are you a health professional able to prescribe or dispense drugs?