Pulmonary artery dissection in long standing idiopathic pulmonary arterial hypertension: A case report |
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| Authors: | Luis Regalado Carol Vitellas Lindsay Wright Asvin Ganapathi Bryan A Whitson Chiemezie Chianotu Amadi |
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| Institution: | aThe Ohio State University, College of Medicine, 370 W 9th Ave, Columbus, OH 43210, USA;bDepartment of Radiology, The Ohio State University, Wexner Medical Center, 395 W 12th Ave, Columbus, OH 43210, USA;cDivision of Cardiac Surgery, Department of Surgery, The Ohio State University, Wexner Medical Center, 410 W. 10th Ave, Columbus OH 43210, USA |
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| Abstract: | Pulmonary arterial dissection (PAD) is a rare and often lethal complication of chronic pulmonary arterial hypertension (PAH), which may occurs in patients with idiopathic pulmonary arterial hypertension (IPAH) and potentially in those with connective tissue disorders. While rare, sudden death often occurs secondary to acute cardiac tamponade, as the pulmonary artery dissects into the pericardium; this diagnosis is often made postmortem. Nevertheless, with the proliferation of multidetector computed tomography (MDCT) as a diagnostic test, patients may be identified very early after symptom onset, prompting rapid intervention with decreased morbidity and mortality. We report a case of IPAH complicated by pulmonary artery aneurysm (PAA) and PAD, diagnosed by CT pulmonary angiogram (CTPA), and treated with bilateral lung transplantation, pulmonic valve replacement, and re-anastomosis of the donor main PA to a pulmonary valve conduit. |
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| Keywords: | Pulmonary hypertension Pulmonary artery aneurysm Pulmonary arterial hypertension Idiopathic pulmonary arterial hypertension Pulmonary artery dissection Lung transplantation |
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