Background:Pulmonary artery aneurysm
(PAA) is an unusual finding and its association withleft main coronary
(LMCA)compression is even more infrequent.Cardiac CT evaluates
of presence and size of PAA and the degree of LMCA compression. The aim of this
study is to describe two cases of adults with compression of LMCA with PAA
associated with PDA and pulmonary hypertension.Case presentation: The first caseis a 27-year-old man
with PAA (78 mm diameter) and LMCA compression of 70% between the aortic sinus
and the PAA. He presented angina as a manifestation of the LMCA compression.
During follow-up the patient died. The second case is a28-year-old man with
PAA (110 mm diameter) that compresses LMCA in 55%, he rejected surgical
treatment, but he is in close follow-up with medical treatment.Conclusion: Cardiac
computed tomography played an important role both in the diagnosis and
identification of high-risk PAA patients.
References
[1]
Gallego, P., Rodriguez-Puras, M.J., Serrano-Gotarredona, P., Valverde, I., Manso, B., Gonzalez-Calle, A., et al. (2018) Prevalence and Prognostic Significance of Pulmonary Artery Aneurysms in Adults with Congenital Heart Disease. International Journal of Cardiology, 270, 120-125. https://doi.org/10.1016/j.ijcard.2018.05.129
[2]
Duijnhouwer, A., Navarese, E., Van Dijk, A., Loeys, B., Roos-Hesselink, J. and Jan De Boer, M. (2016) Aneurysm of the Pulmonary Artery, a Systematic Review and Critical Analysis of Current Literature. Congenital Heart Disease, 11, 102-109.
https://doi.org/10.1111/chd.12316
[3]
Park, H., Chamarthy, M., Lamus, D., Saboo, S., Sutphin, P. and Kalva, S. (2018) Pulmonary Artery Aneurysms: Diagnosis & Endovascular Therapy. Cardiovascular Diagnosis and Therapy, 8, 350-361. https://doi.org/10.21037/cdt.2018.04.01
[4]
Lang, R., Badano, L.P., Mor-Avi, V., Afilalo, J., Armstrong, A., Ernande, L., et al. (2015) Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Journal of the American Society of Echocardiography, 28, 1-39.e14. https://doi.org/10.1016/j.echo.2014.10.003
[5]
Kajita, L.J., Martinez, E.E., Ambrose, J.A., Lemos, P.A., Esteves, A., Nogueira da Gama, M., et al. (2001) Extrinsic Compression of the Left Main Coronary Artery by a Dilated Pulmonary Artery: Clinical, Angiographic, and Hemodynamic Determinants. Catheterization and Cardiovascular Interventions, 52, 49-54.
https://doi.org/10.1002/1522-726X(200101)52:1<49::AID-CCD1012>3.0.CO;2-0
[6]
Lee, M., Oyama, J., Bhatia, R., Kim, Y.H. and Park, S.J. (2010) Left Main Coronary Artery Compression from Pulmonary Artery Enlargement Due to Pulmonary Hypertension: A Contemporary Review and Argument for Percutaneous Revascularization. Catheterization and Cardiovascular Interventions, 76, 543-550.
https://doi.org/10.1002/ccd.22592