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The Annals of Thoracic Surgery Apr 1993We successfully performed a total resection of the pulmonary artery trunk and replaced it with an equine pericardial xenograft roll in a patient with a recurrent... (Review)
Review
We successfully performed a total resection of the pulmonary artery trunk and replaced it with an equine pericardial xenograft roll in a patient with a recurrent leiomyosarcoma. We believe, based on anatomic and embryologic principles, total rather than partial resection of the pulmonary artery trunk should be the treatment of choice for primary leiomyosarcomas of the pulmonary artery.
Topics: Aged; Bioprosthesis; Blood Vessel Prosthesis; Female; Humans; Leiomyosarcoma; Neoplasm Recurrence, Local; Pulmonary Artery; Reoperation; Transplantation, Heterologous; Vascular Diseases
PubMed: 8466316
DOI: 10.1016/0003-4975(93)90139-9 -
The American Journal of Cardiology Dec 1988Clinical and necropsy findings are described in 12 adults (10 men) in whom either the left main coronary artery or the right coronary artery arose abnormally from the... (Review)
Review
Clinical and necropsy findings are described in 12 adults (10 men) in whom either the left main coronary artery or the right coronary artery arose abnormally from the aorta and the anomalistically arising artery coursed thereafter either normally or abnormally, but if abnormally not between the pulmonary trunk and ascending aorta. None of the 12 patients had symptoms of myocardial ischemia that unequivocally could be attributed to the anomalously arising coronary artery. One patient, a 19-year-old man, however, died suddenly and no abnormality other than the anomalistically arising right coronary artery from the posterior aortic valve sinus was found.
Topics: Adult; Aged; Aorta; Coronary Vessel Anomalies; Female; Humans; Male; Middle Aged; Prognosis; Pulmonary Artery
PubMed: 3057853
DOI: 10.1016/0002-9149(88)90271-8 -
The American Journal of Cardiovascular... 1988Spontaneous (nontraumatic, noninfectious) rupture and/or dissection of the pulmonary trunk or secondary pulmonary arteries in the setting of pulmonary hypertension is... (Review)
Review
Spontaneous (nontraumatic, noninfectious) rupture and/or dissection of the pulmonary trunk or secondary pulmonary arteries in the setting of pulmonary hypertension is rarely considered as a cause of sudden death. Systemic-to-pulmonary vascular shunts and rheumatic mitral stenosis have been the most common predisposing factors, occurrence in association with recurrent thromboembolic hypertension rarely having been documented. Recently, we had the opportunity to study a 52-year-old white woman with catheterization-proved "primary" pulmonary hypertension who died suddenly with cardiac tamponade from rupture/dissection of the pulmonary trunk, and who had morphological evidence of extensive thromboembolic pulmonary vascular disease.
Topics: Female; Humans; Hypertension, Pulmonary; Middle Aged; Pulmonary Artery; Rupture, Spontaneous; Vascular Diseases
PubMed: 3061406
DOI: No ID Found -
Journal of Applied Physiology... May 2011Although the distribution of average fetal pulmonary trunk (PT) blood flow favors the ductus arteriosus (DA) over the lungs, the phasic aspects of this distribution...
Although the distribution of average fetal pulmonary trunk (PT) blood flow favors the ductus arteriosus (DA) over the lungs, the phasic aspects of this distribution during systole and diastole are not well understood. Accordingly, flow profile and wave intensity (WI) analyses were performed at baseline and during brief flow increases accompanying an extrasystole (ES) in 10 anesthetized late-gestation fetal sheep instrumented with PT, DA, and left pulmonary artery (PA) micromanometer catheters and transit-time flow probes. At baseline, 83% of mean PT flow crossed the DA and 17% entered the lungs. However, early systolic flow associated with a forward-running compression wave (FCW(is)) was higher in the PA and predominant DA flow only emerged in midsystole when a large PA backward-running compression wave (BCW(ms)), which reduced PA flow, was transmitted into the DA as a forward-running compression wave (FCW(ms)) that increased flow. Subsequent protodiastolic forward DA flow occurring during pulmonary valve closure was associated with substantial retrograde PA flow, but insignificant PT flow. Conversely, forward DA flow in the remainder of diastole occurred with forward PT but near-zero PA flow. These flow and WI patterns, in conjunction with the results of mathematical modeling, suggest that 1) fetal PT flow preferentially passes into the PA during early systole due to a lower PA-than-DA characteristic impedance, while DA flow predominates in mid- and late systole due to flow effects arising from the PA BCW(ms), and 2) forward DA flow is mainly sustained by reversal of PA flow in protodiastole but discharge of a more central reservoir in diastole.
Topics: Animals; Blood Flow Velocity; Blood Pressure; Ductus Arteriosus; Fetus; Pulmonary Artery; Pulmonary Circulation; Sheep
PubMed: 21393465
DOI: 10.1152/japplphysiol.00038.2011 -
Journal of Cardiac Surgery Feb 2022Common arterial trunk with aortic dominance has well-developed bilateral pulmonary arterial arborization without any essential major aortopulmonary collateral arteries...
Large aortopulmonary collateral artery exclusively supplying the lower lobe of left lung in an infant with common arterial trunk with aortic dominance with confluent pulmonary arteries.
INTRODUCTION
Common arterial trunk with aortic dominance has well-developed bilateral pulmonary arterial arborization without any essential major aortopulmonary collateral arteries (MAPCAs), whereas "solitary" arterial trunk is characterized by collateral arterial supply to all bronchopulmonary segments and absent pulmonary arteries.
CASE REPORT
We report a term female neonate with common arterial trunk with aortic dominance with confluent pulmonary arteries with a large MAPCA as the sole blood supply to the lower lobe of the left lung.
RESULTS
Initial diagnostic workup missed this MAPCA from the descending thoracic aorta. It was suspected during surgery due to massive left atrial return and confirmed by cardiac catheterization study in the early postoperative period and treated successfully by unifocalization.
DISCUSSION
A large essential MAPCA supplying an entire lobe in the common arterial trunk with aortic dominance has not been described. It can present as heart failure and inability to wean off the ventilator in the early postoperative period following intracardiac repair.
CONCLUSION
This is a case hitherto undescribed and possibly falling outside the well-entrenched classifications of the common arterial trunk and a large MAPCA could be an addition to the list of lesion modifiers. Our experience with this case underlines the importance of a thorough and open-minded approach to the initial imaging assessment of even well-described conditions.
Topics: Aorta; Collateral Circulation; Female; Humans; Infant; Infant, Newborn; Lung; Pulmonary Artery; Pulmonary Atresia; Truncus Arteriosus, Persistent
PubMed: 34727400
DOI: 10.1111/jocs.16121 -
Kyobu Geka. the Japanese Journal of... Jul 2010Pulmonary trunk aneurysm is generally associated with congenital cardiac defects, pulmonary hypertension, or infection. Idiopathic pulmonary trunk aneurysm without any...
Pulmonary trunk aneurysm is generally associated with congenital cardiac defects, pulmonary hypertension, or infection. Idiopathic pulmonary trunk aneurysm without any associated diseases is a rare lesion and has seldom been reported. Here, we report a case of a 68-year-old woman with idiopathic pulmonary trunk aneurysm. The maximum diameter of the aneurysm was 53 mm while she was 142 cm in height. We successfully performed aneurysmorrhaphy and her postoperative course was uneventful. Aneurysmorrhaphy was an effective technique for idiopathic pulmonary trunk aneurysm without pulmonary hypertention.
Topics: Aged; Aneurysm; Female; Humans; Pulmonary Artery
PubMed: 20662238
DOI: No ID Found -
Cardiology in the Young Jan 1999Banding of the pulmonary trunk is an important surgical procedure for patients who have congenital cardiac malformations with unrestricted pulmonary flow. We propose a... (Clinical Trial)
Clinical Trial
Banding of the pulmonary trunk is an important surgical procedure for patients who have congenital cardiac malformations with unrestricted pulmonary flow. We propose a new concept for determining in such circumstances the most appropriate length of the band used to constrict the pulmonary trunk in preparation for a Fontan operation. We studied 14 patients undergoing banding of the pulmonary trunk and measured the following parameters: diameter of aorta, diameter of pulmonary trunk, length of pulmonary arterial band and maximum flow velocity across the banded segment. We calculated an index from our original parameter based on the formula; length of band/(diameter of aorta diameter of pulmonary trunk). The diameter of aorta was 9.5 +/- 1.4 mm, and that of the pulmonary trunk was 9.6 +/- 2.3 mm. The length of the band was 16.5 +/- 3.4 mm, giving a calculated index of 0.188 +/- 0.038. The maximum flow velocity was 4.02 +/- 0.46 m/s. No correlation was found between the length of the band and body weight, and also no correlation was found between the length of the band and maximum flow velocity. The calculated index had a negative correlation with the maximum velocity of flow across the band (y = -8.13x +/- 5.56, R = 0.74, p < 0.01). We believe that the proposed index is a useful guide in determining the length of a pulmonary band when preparing patients for a Fontan operation.
Topics: Cardiac Catheterization; Cardiac Surgical Procedures; Coronary Circulation; Echocardiography, Doppler; Female; Fontan Procedure; Heart Defects, Congenital; Hemodynamics; Humans; Infant; Infant, Newborn; Male; Palliative Care; Preoperative Care; Prognosis; Pulmonary Artery; Treatment Outcome
PubMed: 10323538
DOI: 10.1017/s104795110000737x -
Khirurgiia 2019Surgical treatment of a patient with primary sarcoma of pulmonary trunk is presented in the article. This rare disease is characterized by poor prognosis if early...
Surgical treatment of a patient with primary sarcoma of pulmonary trunk is presented in the article. This rare disease is characterized by poor prognosis if early diagnosis and adequate surgical treatment are absent.
Topics: Early Diagnosis; Humans; Lung Neoplasms; Pulmonary Artery; Sarcoma; Vascular Neoplasms
PubMed: 31355808
DOI: 10.17116/hirurgia201907110 -
Current Problems in Cardiology Jun 2023Pulmonary hypertension (PH) is defined as an increase in mean pulmonary arterial pressure (mPAP) ≥20 mm Hg at rest as assessed by right cardiac catheterization. It has... (Review)
Review
Pulmonary hypertension (PH) is defined as an increase in mean pulmonary arterial pressure (mPAP) ≥20 mm Hg at rest as assessed by right cardiac catheterization. It has a median survival nowadays of 6 years, compared to 2.8 years in the 1980s. A pulmonary artery aneurysm (PAA) is the focal dilation of a blood vessel involving all 3 layers of the vessel wall; they have a diameter greater than 4 cm measured in the trunk of the pulmonary artery. PAAs can be classified into proximal (or central) and peripheral. The clinical manifestations of PAA are primarily nonspecific, and most patients remain undiagnosed, even those with large PAA, due to its silent course; however, clinical manifestations occur unless when there are complications such as bronchial or tracheal compression (leading to cough and dyspnea), dissection, or rupture (leading to hemoptysis). PAH is observed in 66% of patients with PAA. PA dissections are usually associated with PAH; 80% of dissections occur in the main pulmonary trunk. Although there is no clear guideline for the best treatment of PAA, surgery is indicated in patients with a pulmonary trunk aneurysm >5.5 cm. It has been observed that patients in the PAH group associated with congenital heart disease tend to develop PAA more commonly. Those with PAH associated with connective tissue disease have a smaller diameter of PA dilation. This report presents a comprehensive review of PAA, discussing critical aspects of the clinical and imaging diagnosis, hemodynamics, and treatment. A comprehensive updated literature review is included; we believe this article will interest cardiopulmonologists.
Topics: Humans; Hypertension, Pulmonary; Pulmonary Artery; Aneurysm
PubMed: 36773948
DOI: 10.1016/j.cpcardiol.2023.101645 -
Radiographics : a Review Publication of... 2006Various congenital and acquired anomalies may affect the pulmonary arteries in adult patients. Congenital anomalies (proximal interruption, anomalous origin of the left... (Review)
Review
Various congenital and acquired anomalies may affect the pulmonary arteries in adult patients. Congenital anomalies (proximal interruption, anomalous origin of the left pulmonary artery [pulmonary artery sling], and idiopathic dilatation of the pulmonary trunk) are usually found incidentally at chest radiography or computed tomography (CT). Acquired anomalies include diffuse or focal enlargement of the arteries because of pulmonary hypertension, aneurysm, and intravascular pulmonary metastasis; decreased arterial diameter because of bronchial carcinoma, mediastinal fibrosis, and Takayasu arteritis; and intraluminal filling defects due to pulmonary thromboembolism and pulmonary artery sarcoma. An awareness of the radiologic manifestations of the disease entities and potential pulmonary artery complications secondary to infection or vasculitis may enable an early diagnosis. CT angiography is becoming the standard method for evaluating patients in whom the presence of pulmonary embolism is suspected. CT assessment of the extent of heart effects in patients with pulmonary hypertension and pulmonary embolism is particularly important because such effects largely determine the prognosis.
Topics: Adult; Humans; Image Enhancement; Practice Guidelines as Topic; Practice Patterns, Physicians'; Pulmonary Artery; Tomography, X-Ray Computed
PubMed: 16549603
DOI: 10.1148/rg.262055092