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Journal of Surgical Oncology Apr 2008We report on a sarcoma of the central pulmonary arteries. Surgical therapy consisted in replacing both main pulmonary arteries and the pulmonary trunk including the...
We report on a sarcoma of the central pulmonary arteries. Surgical therapy consisted in replacing both main pulmonary arteries and the pulmonary trunk including the pulmonary valve. Six months later a left-sided pneumonectomy had to be performed due to an intravascular tumor. Fifteen months after first resection treatment, recurrent tumors of the right pulmonary artery and the right ventricle were resected. Two years after the first operation the patient has no detectable tumor.
Topics: Arterial Occlusive Diseases; Blood Vessel Prosthesis; Heart Valve Prosthesis; Humans; Lung Neoplasms; Male; Middle Aged; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Pulmonary Artery; Pulmonary Valve; Sarcoma; Vascular Neoplasms
PubMed: 18286521
DOI: 10.1002/jso.20962 -
Journal of Cardiac Surgery Dec 2022Coronary anatomy is key for arterial switch operations as reimplantation for coronary artery patterns originating from the same sinus is often challenging. We...
Coronary anatomy is key for arterial switch operations as reimplantation for coronary artery patterns originating from the same sinus is often challenging. We experienced an extremely rare coronary artery anatomy case (Leiden convention: 1 R, 1LCx) and successfully performed an arterial switch operation with coronary button extension and neo-pulmonary trunk realignment maneuver.
Topics: Humans; Arterial Switch Operation; Transposition of Great Vessels; Heart; Pulmonary Artery; Coronary Vessels; Coronary Vessel Anomalies
PubMed: 36378943
DOI: 10.1111/jocs.17188 -
Medical Image Computing and... 2010Congenital heart defect is the primary cause of death in newborns, due to typically complex malformation of the cardiac system. The pulmonary valve and trunk are often...
Congenital heart defect is the primary cause of death in newborns, due to typically complex malformation of the cardiac system. The pulmonary valve and trunk are often affected and require complex clinical management and in most cases surgical or interventional treatment. While minimal invasive methods are emerging, non-invasive imaging-based assessment tools become crucial components in the clinical setting. For advanced evaluation and therapy planning purposes, cardiac Computed Tomography (CT) and cardiac Magnetic Resonance Imaging (cMRI) are important non-invasive investigation techniques with complementary properties. Although, characterized by high temporal resolution, cMRI does not cover the full motion of the pulmonary trunk. The sparse cMRI data acquired in this context include only one 3D scan of the heart in the end-diastolic phase and two 2D planes (long and short axes) over the whole cardiac cycle. In this paper we present a cross-modality framework for the evaluation of the pulmonary trunk, which combines the advantages of both, cardiac CT and cMRI. A patient-specific model is estimated from both modalities using hierarchical learning-based techniques. The pulmonary trunk model is exploited within a novel dynamic regression-based reconstruction to infer the incomplete cMRI temporal information. Extensive experiments performed on 72 cardiac CT and 74 cMRI sequences demonstrated the average speed of 110 seconds and accuracy of 1.4mm for the proposed approach. To the best of our knowledge this is the first dynamic model of the pulmonary trunk and right ventricle outflow track estimated from sparse 4D cMRI data.
Topics: Algorithms; Heart Defects, Congenital; Humans; Image Enhancement; Image Interpretation, Computer-Assisted; Magnetic Resonance Imaging; Pattern Recognition, Automated; Pulmonary Artery; Reproducibility of Results; Sensitivity and Specificity; Subtraction Technique; Tomography, X-Ray Computed
PubMed: 20879263
DOI: 10.1007/978-3-642-15705-9_56 -
Cardiology in the Young Aug 2022Malposition of the branch pulmonary arteries (MBPA) is an unusual malformation characterised by anomalous origin of both pulmonary arteries from the main pulmonary... (Review)
Review
Malposition of the branch pulmonary arteries (MBPA) is an unusual malformation characterised by anomalous origin of both pulmonary arteries from the main pulmonary trunk. To date, only few cases have been reported. Herein, we present the first case report of a 3-day-old, full-term male neonate with the lesser form of crossed pulmonary arteries in Saudi Arabia detected by echocardiography and confirmed by cardiac CT. Crossed pulmonary arteries is not a rare anomaly, but it is a somewhat underreported anomaly, and their recognition is important because it is usually associated with other CHDs, airway obstruction, extra-cardiac anomalies, and certain genetic syndromes.
Topics: Coronary Vessel Anomalies; Echocardiography; Heart Defects, Congenital; Humans; Infant, Newborn; Male; Pulmonary Artery; Saudi Arabia; Tomography, X-Ray Computed
PubMed: 35912648
DOI: 10.1017/S1047951122002098 -
Internal Medicine (Tokyo, Japan) 2012
Topics: Adult; Contraceptives, Oral, Hormonal; Female; Humans; Pulmonary Artery; Thrombosis; Venous Thrombosis
PubMed: 22293815
DOI: 10.2169/internalmedicine.51.6548 -
American Journal of Respiratory Cell... Mar 2021Monoamine oxidases (MAOs), a class of enzymes bound to the outer mitochondrial membrane, are important sources of reactive oxygen species. Increased MAO-A activity in...
Monoamine oxidases (MAOs), a class of enzymes bound to the outer mitochondrial membrane, are important sources of reactive oxygen species. Increased MAO-A activity in endothelial cells and cardiomyocytes contributes to vascular dysfunction and progression of left heart failure. We hypothesized that inhibition of MAO-A can be used to treat pulmonary arterial hypertension (PAH) and right ventricular (RV) failure. MAO-A levels in lung and RV samples from patients with PAH were compared with levels in samples from donors without PAH. Experimental PAH was induced in male Sprague-Dawley rats by using Sugen 5416 and hypoxia (SuHx), and RV failure was induced in male Wistar rats by using pulmonary trunk banding (PTB). Animals were randomized to receive either saline or the MAO-A inhibitor clorgyline at 10 mg/kg. Echocardiography and RV catheterization were performed, and heart and lung tissues were collected for further analysis. We found increased MAO-A expression in the pulmonary vasculature of patients with PAH and in experimental experimental PAH induced by SuHx. Cardiac MAO-A expression and activity was increased in SuHx- and PTB-induced RV failure. Clorgyline treatment reduced RV afterload and pulmonary vascular remodeling in SuHx rats through reduced pulmonary vascular proliferation and oxidative stress. Moreover, clorgyline improved RV stiffness and relaxation and reversed RV hypertrophy in SuHx rats. In PTB rats, clorgyline had no direct clorgyline had no direct effect on the right ventricle effect. Our study reveals the role of MAO-A in the progression of PAH. Collectively, these findings indicated that MAO-A may be involved in pulmonary vascular remodeling and consecutive RV failure.
Topics: Animals; Clorgyline; Disease Models, Animal; Disease Progression; Heart Ventricles; Humans; Hypertrophy, Right Ventricular; Indoles; Monoamine Oxidase; Oxidative Stress; Pulmonary Arterial Hypertension; Pulmonary Artery; Pyrroles; Rats; Vascular Remodeling; Vascular Stiffness; Vasodilation
PubMed: 33264068
DOI: 10.1165/rcmb.2020-0105OC -
Journal of Cardiothoracic Surgery May 2024Pulmonary arterial sarcomas (PAS) are rare aggressive tumours occurring mainly in the pulmonary trunk. We report a case of PAS involving the pulmonary trunk wall and... (Review)
Review
Pulmonary arterial sarcomas (PAS) are rare aggressive tumours occurring mainly in the pulmonary trunk. We report a case of PAS involving the pulmonary trunk wall and valve, with uniform wall thickening which represents an atypical imaging manifestation of this tumour. A 63-year-old male presented with vague respiratory symptoms with rapid progression. CTPA showed low density filling defects in both pulmonary arteries and PET scan showed increased uptake in the pulmonary trunk, which along with raised ESR suggested Pulmonary Vasculitis. Echo imaging showed Right ventricular hypertrophy and pulmonary stenosis. Response to steroid therapy was minimal and his symptoms worsened. A referral for second opinion was made and he was diagnosed with PAS. He underwent Pulmonary thromboendarterectomy with Pulmonary valve replacement. Post-operative histopathology confirmed the diagnosis. PAS is rare and frequently misdiagnosed. Surgical resection is not curative, but together with chemotherapy can prolong survival.
Topics: Humans; Male; Middle Aged; Pulmonary Artery; Sarcoma; Pulmonary Valve; Vascular Neoplasms; Diagnosis, Differential; Vasculitis; Diagnostic Errors
PubMed: 38745263
DOI: 10.1186/s13019-024-02700-3 -
The Annals of Thoracic Surgery Jun 2004In hearts with congenitally corrected transposition of the great arteries, the atrial and ventricular septums are usually malaligned. This is associated with an abnormal...
BACKGROUND
In hearts with congenitally corrected transposition of the great arteries, the atrial and ventricular septums are usually malaligned. This is associated with an abnormal location of the atrioventricular conduction system. However, well-aligned septums and normally positioned atrioventricular conduction tissues have been found in a few cases, some of which also happened to have a small or atretic pulmonary trunk. Our aim was to determine whether septal alignment could be predicted on the basis of the size of the pulmonary trunk. Potentially this could provide a guide to the disposition of the atrioventricular conduction tissues.
METHODS
We examined 14 hearts. In all cases there was usual atrial arrangement. We carried out histologic examination of the sites of the atrioventricular conduction tissues in 1 heart.
RESULTS
We found a statistically significant correlation between the size of the pulmonary trunk and the degree of septal malalignment. In the presence of a small or atretic pulmonary trunk, the septums were well aligned. Our histologic study of one such specimen revealed dual atrioventricular nodes connecting to a sling of conduction tissue. This suggests that presence of a postero-inferiorly situated atrioventricular conduction bundle in addition to an anteriorly located bundle may be anticipated when the septums are well aligned.
CONCLUSIONS
The presence of a small or atretic pulmonary trunk in congenitally corrected transposition of the great arteries is associated with good septal alignment. This should alert the surgeon to the possibility of a slinglike arrangement of the atrioventricular conduction system.
Topics: Atrial Appendage; Atrioventricular Node; Heart Conduction System; Heart Septum; Humans; Pulmonary Artery; Transposition of Great Vessels
PubMed: 15172288
DOI: 10.1016/j.athoracsur.2003.11.046 -
Journal of Veterinary Cardiology : the... Apr 2021A 6-month-old female cat presented with respiratory distress. Physical examination showed a grade 5/6 holosystolic murmur with prominent precordial impulse over the left...
A 6-month-old female cat presented with respiratory distress. Physical examination showed a grade 5/6 holosystolic murmur with prominent precordial impulse over the left cranial chest wall. Echocardiography revealed bilateral hypertrophy of the ventricular walls, a dilated ascending aorta overriding the interventricular septum, a membranous ventricular septal defect and no obvious pulmonary trunk or pulmonary artery branches. Turbulent blood flow was detected around the ventricular septal defect and ascending aorta. Follow-up assessment, 12 months later, revealed marked and progressive biatrial dilation and biventricular hypertrophy. Four months after that, the cat died of severe congestive heart failure. To make a definitive postmortem diagnosis, we performed contrast enhanced micro-computed tomography (CT) on the ex vivo heart with micron-scale spatial resolution imaging and three-dimensional reconstruction. Micro-computed tomography analysis confirmed a common arterial trunk that bifurcated into the left pulmonary artery and aorta 5-mm distally from the truncal valve. The pulmonary trunk was absent. Slightly distal to the first branching, the common arterial trunk further branched into the right pulmonary artery and ascending aorta, indicating the aortic dominant form. Although CT angiography would be a preferred imaging modality for living animals, micro-computed tomography is a valuable tool for the ex vivo diagnosis of complex cardiac anomaly, such as presented in this cat.
Topics: Animals; Cat Diseases; Cats; Echocardiography; Female; Heart Defects, Congenital; Heart Septal Defects, Ventricular; Pulmonary Artery; Truncus Arteriosus, Persistent; X-Ray Microtomography
PubMed: 33486210
DOI: 10.1016/j.jvc.2020.12.003 -
European Journal of Pediatrics Jan 1995Pulmonary sling (PS) is a congenital condition in which the left pulmonary artery (LPA) arises from the right pulmonary artery (RPA), forming a sling around the trachea... (Review)
Review
Pulmonary sling (PS) is a congenital condition in which the left pulmonary artery (LPA) arises from the right pulmonary artery (RPA), forming a sling around the trachea causing tracheal compression. The incidence is not so rare as initially thought. Symptoms of severe airway obstruction often begin in the newborn or young infant. Echo-colour-Doppler may reveal the PS but emphysema can mask the typical findings. Deviation of fluid-filled lungs may be detected prenatally. Chest radiographs show unusual air distribution, deviation of heart and mediastinum and altered tracheobronchial angles. Bronchography and bronchoscopy demonstrate the high incidence of associated tracheal anomalies such as cartilagenous rings and long tracheal stenosis. Anterior oesophageal indentation is not always seen in the oesophogram. Magnetic resonance imaging (MRI) and computed tomography (CT) reveal the PS, but cautious interpretation is necessary because of different levels of the anomalous LPA. PS and associated cardiovascular malformations can be clearly detected by angiography. Associated extrathoracic anomalies are common. Early diagnosis and therapy of PS is mandatory and consists of reimplantation of the LPA into the pulmonary trunk and division of the ligamentum arteriosum. The postoperative course may be cumbersome necessitating bronchological interventions. Tracheal resection may be necessary but restenosis is frequent. A one-stage repair has been proposed in such cases and was successfully done in a few reported cases. Relief of respiratory obstruction is often complete when there are no associated tracheobronchial anomalies. Late postoperative course is favourable but respiratory obstructive attacks may occur with decreasing incidence over time and tracheal growth.
Topics: Abnormalities, Multiple; Airway Obstruction; Emphysema; Female; Humans; Infant; Infant, Newborn; Male; Postoperative Complications; Prognosis; Pulmonary Artery; Radiography; Tracheal Stenosis; Ultrasonography
PubMed: 7895751
DOI: 10.1007/BF01972965