Our hospital received a
51-year-old man because of chest discomfort. Clinical examination
revealed systolic and diastolic heart murmurs without any systolic click
in the inferior right sternal border. A Chest x-ray showed pulmonary
artery dilation (Figure 1). Multidetector computed tomography showed a
substantial pulmonary artery aneurysm (arrow)52 mm in diameter (Figure
2A). Transthoracic echocardiography showed a massive aneurysm of the
pulmonary artery by 2D echocardiography. There was nonsignificant
mitral, tricuspid, and pulmonary valve regurgitation in either the
4-chamber view or the short-axis. Cardiac catheterization did not show
any pressure gradient between the pulmonary artery and right ventricle
or any pulmonary hypertension sign. The main pulmonary artery(arrow)
thickened during the operation
(Figure2C). Aneurysmectomy of the
main pulmonary trunk with a 26-mm synthetic graft performed (Figure2D).
The postoperative multidetector computed tomography showed pulmonary
trunk(arrow) 29 mm in diameter (Figure 2B).
The pathological examination did
show blood vessel wall thickens, smooth muscle hyperplasia(Figure 3).
The patient recovered well and was discharged 10 days after surgery.
Figure
1. Chest x-ray showing pulmonary
artery aneurysm.
Figure 2. Three-dimensional
reconstruction of chest computed tomography showing the main pulmonary
artery and intra-operative image A) Before the operation(arrow)B) The
fifth day after surgery (arrow)C, D) Intra-operative image showing the
giant pulmonary aneurysm(arrow).
Figure 3. The pathological
examination did show blood vessel wall thickens, smooth muscle
hyperplasia.