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Journal of Thoracic Imaging Nov 2016Coronary-pulmonary arterial fistulas (CPAFs) are rare coronary artery anomalies that have been described only in limited case reports. This study aims to evaluate the... (Review)
Review
PURPOSE
Coronary-pulmonary arterial fistulas (CPAFs) are rare coronary artery anomalies that have been described only in limited case reports. This study aims to evaluate the clinical presentation and imaging findings of CPAFs collected from 6 participating medical centers along with CPAFs reported in the literature, to discern any general trends present in CPAFs.
MATERIALS AND METHODS
A total of 25 cases of CPAF diagnosed by coronary computed tomography angiography were collected across 6 participating institutions. In addition, utilizing a PubMed literature search, 78 additional CPAF cases were obtained. The imaging findings and relevant clinical history were reviewed.
RESULTS
Of the 103 CPAF patients, 60 (63% of patients with sex known) were male, with ages ranging from newborn to 88 years (mean=46.1 y). The most common symptoms reported were chest pain (n=40, 39%) and dyspnea (n=26, 25%), with a murmur as the most common physical examination finding (n=38, 37%). The most common coronary artery of origin for a CPAF was the left main/left anterior descending (n=87, 84%), followed by the right coronary artery (n=39, 38%). The fistula most commonly terminated in the main pulmonary artery (n=92, 89%). Multiple CPAFs were present in 46 cases (45%). Coronary artery aneurysms were identified in 20 cases (19%). Pediatric CPAF cases were usually associated with pulmonary atresia with ventricular septal defect.
CONCLUSIONS
CPAFs are seen in a variety of clinical settings, from infants with advanced congenital heart disease to elderly patients who have undergone revascularization surgery. Although coronary artery fistulas have previously been described as rarely involving multiple coronary arteries, with the right coronary artery being most often involved, our series demonstrates that multiple fistulas are commonly present, with the most common pattern being between the left main/left anterior descending and the main pulmonary trunk.
Topics: Arterio-Arterial Fistula; Computed Tomography Angiography; Coronary Angiography; Coronary Vessel Anomalies; Coronary Vessels; Humans; Pulmonary Artery
PubMed: 27768631
DOI: 10.1097/RTI.0000000000000232 -
Clinical Cardiology Aug 1997This five-part review focuses on selected nonneoplastic diseases of the aorta and pulmonary trunk. Because many more diseases affect the aorta compared with the... (Review)
Review
This five-part review focuses on selected nonneoplastic diseases of the aorta and pulmonary trunk. Because many more diseases affect the aorta compared with the pulmonary trunk and right and left main pulmonary arteries, most of this review will be devoted to disorders of the aorta. Part I of this five-part review discusses general concepts of aorta anatomy and aortic dissection.
Topics: Aortic Dissection; Aortic Aneurysm; Aortic Diseases; Arteriosclerosis; Humans; Pulmonary Artery
PubMed: 9259168
DOI: 10.1002/clc.4960200813 -
Journal of Cardiac Surgery May 2022We present a case of a 45-year-old man with atypical chest pain who underwent coronary computed tomography angiography which incidentally revealed a conglomerate of...
We present a case of a 45-year-old man with atypical chest pain who underwent coronary computed tomography angiography which incidentally revealed a conglomerate of nondilated tortuous vessels along the inferior half of the surface of the pulmonary trunk, resulting in a "ground-cherry" like ridged appearance. Tracing these vessels proximally and distally revealed it to be arising from the sinoatrial nodal branch of the right coronary artery and distally draining into the left anterolateral aspect of the pulmonary trunk.
Topics: Arterio-Arterial Fistula; Computed Tomography Angiography; Coronary Angiography; Coronary Vessel Anomalies; Fistula; Humans; Male; Middle Aged; Physalis; Pulmonary Artery
PubMed: 35218054
DOI: 10.1111/jocs.16357 -
Thorax Mar 1980The appearance of the endothelial pavement pattern was studied in the pulmonary trunk, pulmonary veins, aorta, and inferior vena cava of the rat by means of silver...
The appearance of the endothelial pavement pattern was studied in the pulmonary trunk, pulmonary veins, aorta, and inferior vena cava of the rat by means of silver staining of the cell borders. The endothelial cell in each of the four blood vessels was found to have its own distinctive shape, fusiform and pointed in the direction of blood flow in the case of the aorta and larger and more rectangular in the pulmonary trunk and pulmonary veins. Detailed quantitation of the dimensions and surface area of the endothelial cells in each blood vessel was carried out by a photographic technique. Pulmonary hypertension was induced in one group of rats by feeding them on Crotalaria spectabilis seeds. The endothelial pavement pattern in their pulmonary trunks became disrupted with many of the cells assuming a fusiform shape reminiscent of aortic endothelium. Many small, new endothelial cells formed in the pulmonary trunk suggesting division of cells to line the enlarging blood vessels. In contrast the endothelial cells of the inferior vena cava merely increased in size to cope with the dilatation of this vein.
Topics: Animals; Aorta; Endothelium; Female; Hypertension, Pulmonary; Photomicrography; Pulmonary Artery; Pulmonary Veins; Rats; Vena Cava, Inferior
PubMed: 7385090
DOI: 10.1136/thx.35.3.186 -
Chinese Medical Journal May 2019
Topics: Humans; Hypertension, Pulmonary; Lung Transplantation; Male; Middle Aged; Pulmonary Artery; Stents
PubMed: 30882457
DOI: 10.1097/CM9.0000000000000209 -
European Heart Journal Jul 2021
Topics: Aneurysm, False; Aorta; Fistula; Humans; Pulmonary Artery; Pulmonary Edema
PubMed: 33026083
DOI: 10.1093/eurheartj/ehaa712 -
Journal of Cardiac Surgery Mar 2011A 60-year-old male being treated for chronic venous stasis ulcers presented with an asymptomatic pulmonary artery aneurysm involving the main pulmonary trunk and...
A 60-year-old male being treated for chronic venous stasis ulcers presented with an asymptomatic pulmonary artery aneurysm involving the main pulmonary trunk and extending into both pulmonary arteries. He underwent successful resection of the aneurysm, and his chronic ulcerations recovered spontaneously. Surgical treatment of pulmonary artery aneurysm could be found in reports from Wilms and Sauerbruch dating from the early twenties of the last century. In 1950, Blades et al. reported a ligation of an aneurysmatic pulmonary artery with lung resection. However, the role of surgery in main pulmonary artery aneurysms is still not well defined. In this report, we describe the management of an extensive pulmonary artery aneurysm in a patient with chronic venous stasis ulcers.
Topics: Aneurysm; Follow-Up Studies; Humans; Male; Middle Aged; Pulmonary Artery; Pulmonary Circulation; Tomography, X-Ray Computed; Vascular Surgical Procedures
PubMed: 21155999
DOI: 10.1111/j.1540-8191.2010.01166.x -
Journal of Cardiac Surgery Dec 2019A pulmonary artery sling is formed when the left pulmonary artery originates from the right pulmonary artery and encircles the distal trachea, coursing between the...
A pulmonary artery sling is formed when the left pulmonary artery originates from the right pulmonary artery and encircles the distal trachea, coursing between the trachea and esophagus to reach the hilum of the left lung. Pulmonary artery slings are often associated with distal tracheal narrowing, due to either intrinsic stenosis or secondary compression by the anomaly itself. We report a very rare case in which the left superior pulmonary artery originated from the right pulmonary artery and then acted as a sling, the left inferior pulmonary artery originated from the pulmonary trunk.
Topics: Humans; Infant; Male; Pulmonary Artery; Vascular Malformations
PubMed: 31557345
DOI: 10.1111/jocs.14268 -
Modern Pathology : An Official Journal... Sep 1989Pulmonary artery sarcomas are rare tumors that arise in the region of the bulbus cordis, the embryologic structure that gives rise to the pulmonary trunk. Nearly 100... (Review)
Review
Pulmonary artery sarcomas are rare tumors that arise in the region of the bulbus cordis, the embryologic structure that gives rise to the pulmonary trunk. Nearly 100 cases have been reported in the literature, yet considerable debate exists regarding the histogenesis and biologic properties of these neoplasms. We report four additional cases in which ultrastructural and immunohistochemical studies demonstrated that these tumors contain cellular constituents with features of myofibroblastic, cartilaginous, and osteogenic differentiation. Polyphenotypic expression of several mesenchymal lineages suggests that the progenitor cell has pluripotential properties. Our findings and a review of the literature appear to confirm that pulmonary artery sarcomas are histopathologically heterogeneous, possibly reflecting the indeterminate character of the mesenchymal cell(s) of origin. The poor prognosis is attributable to the critical anatomic location of the neoplasm rather than its metastatic potential, which is low.
Topics: Actins; Adolescent; Aged; Female; Humans; Immunoenzyme Techniques; Male; Middle Aged; Pulmonary Artery; Retrospective Studies; Sarcoma; Vimentin; alpha 1-Antichymotrypsin; alpha 1-Antitrypsin
PubMed: 2682615
DOI: No ID Found -
Cardiology in the Young Feb 2007Patients with anomalous origin of the left coronary artery from the pulmonary trunk may present with paroxysmal angina on exertion, congestive heart failure, dyspnoea,... (Review)
Review
Patients with anomalous origin of the left coronary artery from the pulmonary trunk may present with paroxysmal angina on exertion, congestive heart failure, dyspnoea, syncope or sudden death. The association of such anomalous origin of the left coronary artery from the pulmonary trunk with a hypertrophic left ventricle is extremely rare. In our cohort of patients with anomalous origin of the left coronary artery from the pulmonary trunk, two presented with a hypertrophic left ventricle. We discuss these cases, accompanied by a review of the English literature describing different morphological anomalies of the coronary arteries associated with left ventricular hypertrophy. Whether the hypertrophy is a result of the evolvement of the collateral coronary system, or due to an additional pathological gene for hypertrophic obstructive cardiomyopathy, remains an enigma. The hypertrophy may have served as a compensatory mechanism accounting for the atypical clinical presentation. We further discuss the possible factors associating the occurrence of anomalous origin of the left coronary artery from the pulmonary trunk and myohypertrophy, supported by the documentation of the regression of hypertrophy following surgical correction of the anomalous arterial origin as seen in our patients.
Topics: Adult; Child; Combined Modality Therapy; Coronary Vessel Anomalies; Diagnosis, Differential; Echocardiography, Doppler; Electrocardiography; Female; Humans; Hypertrophy, Left Ventricular; Male; Pulmonary Artery
PubMed: 17244377
DOI: 10.1017/S104795110700008X