114 results on '"Pulmonary artery dilatation"'
Search Results
2. Pulmonary Artery Dilatation Due to Pressure or Volume Overload in Congenital Heart Disease.
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Kaldararova, Monika, Bobocka, Katarina, Kantorova, Andrea, Drangova, Erika, Polakova Mistinova, Jana, Klauco, Filip, Hlavata, Tereza, Reptova, Adriana, Valkovicova, Tatiana, and Simkova, Iveta
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PULMONARY artery , *CONGENITAL heart disease , *PULMONARY arterial hypertension , *MAGNETIC resonance imaging , *TETRALOGY of Fallot - Abstract
Background: Pulmonary artery dilatation is described mostly in association with pulmonary hypertension. Patients/Methods: Study analysis: 60 patients with pulmonary arterial hypertension in congenital heart disease (PAH-CHD); 64 with repaired tetralogy of Fallot/pulmonary regurgitation (rTOF/PR); and 80 healthy (NORMAL). Measured were: main pulmonary artery (MPA) diameter and MPA/ascending aorta (Ao asc) ratio, by echocardiography (ECHO) and computer tomography or magnetic resonance imaging (CT/MRI). Results: In MPA diameter, significant differences between PAH-CHD, rTOF/PR, and NORMAL were found (median): 37 vs. 27 vs. 21 mm (p < 0.0001). In MPA/Ao asc ratio, there was a difference between PAH-CHD and NORMAL (median): 1.3 vs. 0.8 (p < 0.0001), but not between rTOF/PR and NORMAL: 0.74 vs. 0.8 (p = 0.3). Significant MPA dilatation (>40 mm) was present: in PAH-CHD, 35% (ECHO) and 76.9% (CT/MRI) of patients, while in rTOF/PR, 3.1% (ECHO) and 7.8% (CT/MRI). Severe MPA dilatation (>50 mm) occurred only in PAH-CHD: 16.7% (ECHO) and 31.4% (CT/MRI), while not in rTOF/PR. There was a significant correlation between ECHO and CT/MRI measurements, but ECHO was underestimated in all parameters. Conclusions: MPA dilatation due to pressure overload is more frequent and more severe; volume overload also leads to MPA dilatation but is less severe. The MPA/Ao asc ratio is not reliable for MPA dilatation estimation in rTOF/PR. [ABSTRACT FROM AUTHOR]
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- 2024
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3. Pulmonary artery dilatation in different causes of pulmonary hypertension.
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Xi, Qunying, Liu, Zhihong, Xiong, Changming, Luo, Qin, Zhao, Zhihui, Zhao, Qing, Yang, Tao, Zeng, Qixian, Li, Pingwei, and Qiu, Luwen
- Abstract
Pulmonary artery (PA) dilatation is commonly observed in patients with pulmonary hypertension (PH). However, the clinical aspects of PA dilatation in various etiology of PH remain unknown. In this study, we investigated the clinical and imaging characteristics of 1018 patients with different subtypes of pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). The independent determinants for all‐cause death were identified using univariate and multivariate Cox proportional hazard models. PA dilatation was identified in 88.8% of the patients, and 27.2% had a PA diameter/ascending aorta diameter ratio greater than 1.5. PA diameter was shown to be significantly correlated with hemodynamic parameters and symptom duration in idiopathic PAH patients. PA diameter only correlated with pulmonary circulation volume in patients with PAH associated with congenital heart disease. PA diameter correlated with symptom duration and right ventricular end‐diastolic dimension in CTEPH patients. PA diameter correlated with right ventricular end‐diastolic dimension in patients with PAH associated with connective tissue disease. Only 6‐min walk distance, but not PA dilatation, predicts all‐cause death independently. In conclusion, PA dilatation is a common finding in PH patients. The clinical feature of PA dilatation varies greatly between PH types. PA dilatation is not associated with all‐cause death. [ABSTRACT FROM AUTHOR]
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- 2023
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4. Pulmonary artery dilatation in different causes of pulmonary hypertension
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Qunying Xi, Zhihong Liu, Changming Xiong, Qin Luo, Zhihui Zhao, Qing Zhao, Tao Yang, Qixian Zeng, Pingwei Li, and Luwen Qiu
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clinical characteristics ,clinical classification ,pulmonary artery dilatation ,pulmonary hypertension ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 ,Diseases of the respiratory system ,RC705-779 - Abstract
Abstract Pulmonary artery (PA) dilatation is commonly observed in patients with pulmonary hypertension (PH). However, the clinical aspects of PA dilatation in various etiology of PH remain unknown. In this study, we investigated the clinical and imaging characteristics of 1018 patients with different subtypes of pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). The independent determinants for all‐cause death were identified using univariate and multivariate Cox proportional hazard models. PA dilatation was identified in 88.8% of the patients, and 27.2% had a PA diameter/ascending aorta diameter ratio greater than 1.5. PA diameter was shown to be significantly correlated with hemodynamic parameters and symptom duration in idiopathic PAH patients. PA diameter only correlated with pulmonary circulation volume in patients with PAH associated with congenital heart disease. PA diameter correlated with symptom duration and right ventricular end‐diastolic dimension in CTEPH patients. PA diameter correlated with right ventricular end‐diastolic dimension in patients with PAH associated with connective tissue disease. Only 6‐min walk distance, but not PA dilatation, predicts all‐cause death independently. In conclusion, PA dilatation is a common finding in PH patients. The clinical feature of PA dilatation varies greatly between PH types. PA dilatation is not associated with all‐cause death.
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- 2023
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5. Left main coronary artery compression by dilated pulmonary artery in pulmonary arterial hypertension: a systematic review and meta-analysis.
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Badea, Ruxandra, Dorobantu, Dan M., Sharabiani, Mansour T. A., Predescu, Lucian M., Coman, Ioan M., and Ginghina, Carmen
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Objective: Pulmonary arterial hypertension (PAH) can lead to left main coronary artery compression (LMCo), but data on the impact, screening and treatment are limited. A meta-analysis of LMCo cases could fill the knowledge gaps in this topic. Methods: Electronic databases were searched for all LMCo/PAH studies, abstracts and case reports including pulmonary artery (PA) size. Restricted maximum likelihood meta-analysis was used to evaluate LMCo-associated factors. Specificity, sensitivity and accuracy of PA size thresholds for diagnosis of LMCo were calculated. Treatment options and outcomes were summarized. Results: A total of five case–control cohorts and 64 case reports/series (196 LMCo and 438 controls) were included. LMCo cases had higher PA diameter (Hedge's g 1.46 [1.09; 1.82]), PA/aorta ratio (Hedge's g 1.1 [0.64; 1.55]) and probability of CHD (log odds-ratio 1.22 [0.54; 1.9]) compared to non-LMCo, but not PA pressure or vascular resistance. A 40 mm cut-off for the PA diameter had balanced sensitivity (80.5%), specificity (79%) and accuracy (79.7%) for LMCo diagnosis, while a value of 44 mm had higher accuracy (81.7%), higher specificity (91.5%) but lower sensitivity (71.9%). Pooled mortality after non-conservative treatment (n = 150, predominantly stenting) was 2.7% at up to 22 months of mean follow-up, with 83% survivors having no angina at follow-up. Conclusion: PA diameter, PA/aorta ratio and CHD are associated with LMCo, while hemodynamic parameters are not. Data from this study support that a PA diameter cut-off between 40 and 44 mm can offer optimal accuracy for LMCo screening. Preferred treatment was coronary stenting, associated with low mid-term mortality and symptom relief. Diagnosis and management of left main coronary artery compression (LMCo) in patients with pulmonary arterial hypertension (PAH). [ABSTRACT FROM AUTHOR]
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- 2022
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6. Pulmonary Arterial Dilatation: Imaging Evaluation Using Multidetector Computed Tomography
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Sreenivasa Narayana Raju, Niraj Nirmal Pandey, Arun Sharma, Amarinder Singh Malhi, Siddharthan Deepti, and Sanjeev Kumar
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pulmonary artery dilatation ,pulmonary arterial hypertension ,cardiac shunt ,vasculitis ,pulmonary thromboembolism ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Pulmonary artery dilatation comprises a heterogeneous group of disorders. Early diagnosis is important as the presentation may be incidental, chronic, or acute and life threatening depending upon the etiology. Cross-sectional imaging plays an important role, with CT pulmonary angiography being regarded as the first line investigation in the evaluation of pulmonary artery pathologies. Moreover, effects of pulmonary artery lesions on proximal and distal circulation can also be ascertained with the detection of associated conditions. Special attention should also be given to the left main coronary artery and the trachea-bronchial tree as they may be extrinsically compressed by the dilated pulmonary artery. In context of an appropriate clinical background, CT pulmonary angiography also helps in treatment planning, prognostication, and follow-up of these patients. This review mainly deals with imaging evaluation of the pulmonary arterial dilatations on CT with emphasis on the gamut of etiologies in the adult as well as pediatric populations.
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- 2021
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7. Impact of Pulmonary Artery Dilatation on Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement.
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Koseki, Keita, Yoon, Sung-Han, Kaewkes, Danon, Koren, Ofir, Patel, Vivek, Chakravarty, Tarun, Nakamura, Mamoo, Cheng, Wen, Komuro, Issei, and Makkar, Raj
- Abstract
The aim of this study was to evaluate the clinical impact of computed tomography (CT)–derived pulmonary artery dilatation (PAD) in patients undergoing transcatheter aortic valve replacement (TAVR). Several studies have reported an association between pulmonary hypertension and cardiovascular events, but the prognostic value of PAD in patients undergoing TAVR remains unclear. The preprocedural computed tomographic studies of patients who underwent TAVR at Cedars-Sinai Medical Center between November 2013 and December 2017 were analyzed. Patients were divided into 2 groups according to the presence of PAD assessed on CT (pulmonary artery [PA] diameter ≥29 mm). The primary endpoint was all-cause mortality at 2 years. A total of 895 patients were included (mean age 81.3 ± 8.5 years), with a mean Society of Thoracic Surgeons score of 4.8%. The median PA diameter was 28.0 mm, and PAD was observed in 369 patients (41.2%). Compared with the no-PAD group, the PAD group had higher Society of Thoracic Surgeons scores and higher rates of atrial fibrillation, chronic kidney disease, and chronic obstructive pulmonary disease. The PAD group had higher 2-year all-cause mortality than the no-PAD group (28.9% vs 12.8%; P < 0.001), and PAD was independently associated with mortality (adjusted HR: 2.21; 95% CI: 1.44-3.39; P < 0.001). Furthermore, PAD had strong prognostic power in the subgroup analysis, stratified according to PA pressure (>36 mm Hg). CT-derived PAD is a significant prognostic factor in patients undergoing TAVR. [Display omitted] [ABSTRACT FROM AUTHOR]
- Published
- 2021
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8. Obstructive lung disease secondary to compression of the bronchus by an enlarged pulmonary artery
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Justin Panthappattu, Vidhu Sharma, Sameer Verma, and Arunabh Talwar
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bronchial compression ,intrathoracic obstruction ,obstructive lung disease ,pulmonary artery dilatation ,pulmonary hypertension ,Diseases of the respiratory system ,RC705-779 - Abstract
In clinical practice, the presence of wheezing generally indicates an airway disease. In rare circumstances, adjacent mediastinal structures may compress the tracheobronchial tree leading to obstructive physiology. Compression of the tracheobronchial region by an enlarged pulmonary artery (PA) is exceedingly rare. We present here a case of pulmonary hypertension, where the enlarged PA resulted in obstructive lung physiology with a relevant review of the literature.
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- 2020
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9. Unenhanced multidetector computed tomography findings in acute central pulmonary embolism
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Chiao-Hsuan Chien, Fu-Chieh Shih, Chin-Yu Chen, Chia-Hui Chen, Wan-Ling Wu, and Chee-Wai Mak
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CTPA ,High attenuation ,Pulmonary artery dilatation ,Wedge-shaped consolidation ,Medical technology ,R855-855.5 - Abstract
Abstract Background Computed tomography pulmonary angiography (CTPA) is the gold standard for the diagnosis of pulmonary embolism (PE). However, contrast is contraindicated in some patients. The purpose of this study was to determine the diagnostic accuracy of unenhanced multidetector CT (MDCT) for diagnosis of central PE using CTPA as the gold standard. Methods The records of patients with suspected PE seen between 2010 and 2013 were retrospectively reviewed. Inclusion criteria were an acute, central PE confirmed by CTPA and non-enhanced MDCT before contrast injection. Patients with a PE ruled out by CTPA served as a control group. MDCT findings studied were high-attenuation emboli in pulmonary artery (PA), main PA dilatation > 33.2 mm, and peripheral wedge-shaped consolidation. Receiver operating characteristic (ROC) analysis was used to determine the sensitivity and specificity of unenhanced MDCT to detect PE. Wells score of all patients were calculated using data extracted from medical records prior to imaging analysis. Results Thirty-two patients with a PE confirmed by CTPA and 32 with a PE ruled out by CTPA were included. Among the three main MDCT findings, high-attenuation emboli in the PA showed best diagnostic performance (Sensitivity 72.9%; Specificity 100%), followed by main PA dilatation > 33.2 mm (sensitivity 46.9%; specificity 90.6%), and peripheral wedge-shaped consolidation (sensitivity 43.8%; specificity 78.1%). Given any one or more positive findings on unenhanced MDCT, the sensitivity was 96.9% and specificity was 71.9% for a diagnosis of PE in patients. The area under the curve (AUC) of a composite measure of unenhanced MDCT findings (0.909) was significantly higher than that of the Wells score (0.688), indicating unenhanced MDCT was reliable for detecting PE than Wells score. Conclusions Unenhanced MDCT is an alternative for the diagnosis of acute central PE when CTPA is not available.
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- 2019
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10. Pulmonary Arterial Dilatation: Imaging Evaluation Using Multidetector Computed Tomography.
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Raju, Sreenivasa Narayana, Pandey, Niraj Nirmal, Sharma, Arun, Malhi, Amarinder Singh, Deepti, Siddharthan, and Kumar, Sanjeev
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BLOOD vessels , *DILATATION & curettage , *PULMONARY hypertension , *PULMONARY artery , *COMPUTED tomography , *DECISION making in clinical medicine , *ADULTS , *CHILDREN - Abstract
Pulmonary artery dilatation comprises a heterogeneous group of disorders. Early diagnosis is important as the presentation may be incidental, chronic, or acute and life threatening depending upon the etiology. Cross-sectional imaging plays an important role, with CT pulmonary angiography being regarded as the first line investigation in the evaluation of pulmonary artery pathologies. Moreover, effects of pulmonary artery lesions on proximal and distal circulation can also be ascertained with the detection of associated conditions. Special attention should also be given to the left main coronary artery and the trachea-bronchial tree as they may be extrinsically compressed by the dilated pulmonary artery. In context of an appropriate clinical background, CT pulmonary angiography also helps in treatment planning, prognostication, and follow-up of these patients. This review mainly deals with imaging evaluation of the pulmonary arterial dilatations on CT with emphasis on the gamut of etiologies in the adult as well as pediatric populations. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
11. Unfavorable postnatal outcome with significant dilation of the fetal main pulmonary artery near term.
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Murlewska, Julia, Sylwestrzak, Oskar, and Respondek‐Liberska, Maria
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Introduction: Fetal echocardiography in third trimester is relatively rare reported and there is no data, what is the clinical meaning of the main pulmonary artery (MPA) dilatation in third trimester or before the delivery in fetuses with congenital heart defect. We analyzed the neonatal follow‐up in cases of significantly dilated MPA diameter to better understand its clinical significance. Material and Methods: Retrospectively 238 healthy singleton fetuses were selected as a reference group. Consecutive percentiles for MPA diameter according to the gestational age were calculated. In second step, we selected cases whose MPA diameter measured at the level of three vessel trachea view (3VT view) was pointedly above 95th centile in third trimester of pregnancy, according to the obtained data of our healthy population. Results: There were 11 fetuses, with dilated MPA diameter (range 12–13.5 mm), who had last echocardiography performed at 37.6 weeks of gestation. There were 11 isolated heart defects: 7 cases with HLHS, 2 with d‐TGA, and 2 cases with CoA. Mean neonatal weight was 3,345 g, with Apgar score 8–10. About 10 newborns out of 11 had cardiac surgery at the mean 12th day of the postnatal life and 8 of them died on the mean 23rd day. Autopsy was performed in 5 cases. In all of them histopathology reports described pulmonary hypertension in addition to cardiac structural abnormalities. Conclusion: Severe dilation of the fetal MPA before the delivery suggested prenatal abnormal lung development and was a poor prognostic factor. In these cases postnatal pulmonary hypertension should be suspected. [ABSTRACT FROM AUTHOR]
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- 2021
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12. Cardiac Management
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Isekame, Yukiko, Gati, Sabiha, and Child, Anne H., editor
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- 2016
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13. Prevalence and prognostic significance of pulmonary artery aneurysms in adults with congenital heart disease.
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Gallego, Pastora, Rodríguez-Puras, María José, Serrano Gotarredona, Pilar, Valverde, Israel, Manso, Begoña, González-Calle, Antonio, Adsuar, Alejandro, Cubero, Jose M., Díaz de la Llera, Luis, Ordoñez, Antonio, and Hosseinpour, Amir-Reza
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CONGENITAL heart disease , *HYPERTENSION , *PROGNOSIS , *DISEASE risk factors - Abstract
Abstract Background Prevalence and prognostic significance of pulmonary artery (PA) dilatation in congenital heart disease (CHD) have never been studied systematically. Methods Chest X-rays of 1192 consecutive adults with CHD were reviewed. Major diameter of the PA was determined by imaging techniques in those with PA dilatation. A value >29 mm was considered abnormal. Data on anatomy, hemodynamics, residual lesions and outcomes were retrospectively collected. Results Overall prevalence of PA dilatation was 18%. A minority of patients (5.5%) reached 40 mm (aneurysm; PAA) and 1.8% exceeded 50 mm. The most common PAA underlying malformations were pulmonary stenosis (21%), and shunts (55%). Significantly larger diameters were observed in hypertensive shunts (40 mm; IQR 36.7–45 mm vs. 34 mm; IQR 32–36 mm) (p < 0.0001). However, the largest diameters were found in cono-truncal anomalies. There was no significant correlation between PA dimensions and systolic pulmonary pressure (r = −0.196), trans-pulmonary gradient (r = −0.203), pulmonary regurgitation (PR) (r = 0.071) or magnitude of shunt (r = 0.137) (p > 0.05 for all). Over follow-up, 1 sudden death (SD) occurred in one Eisenmenger patient. Complications included coronary (3), recurrent laryngeal nerve (1) and airway (1) compressions, progressive PR (1), and PA thrombosis (1). Coronary compression and SD were strongly associated (univariate analysis) with pulmonary hypertension (120 vs. 55 mm Hg; p = 0.002) but not with extreme PA dilatation (range: 40–65 mm). Conclusions PA dilatation in CHD is common but only a small percentage of patients have PAA. Clinical impact on outcomes is low. Complications occurred almost exclusively in patients with pulmonary hypertension whereas PA diameter alone was not associated with adverse outcomes. Highlights • Pulmonary artery aneurysms are rare in adults with congenital heart disease, even though dilatation is a common finding. • Clinical impact of pulmonary artery dilatation on outcomes of patients with congenital heart disease is low • Complications occurr almost exclusively in patients with pulmonary hypertension. Dilatation alone is not related with adverse outcomes [ABSTRACT FROM AUTHOR]
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- 2018
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14. All in the Family: A Curious Case of Aortopathy
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Evan Stern, Saira Bilal, and Erica McBride
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medicine.medical_specialty ,business.industry ,Deep vein ,Pulmonary artery dilatation ,medicine.disease ,Thoracic aortic aneurysm ,Thrombosis ,Aortic aneurysm ,medicine.anatomical_structure ,Rheumatology ,Large vessel vasculitis ,cardiovascular system ,Medicine ,cardiovascular diseases ,Radiology ,Headaches ,medicine.symptom ,business ,Lower limbs venous ultrasonography - Abstract
A 28-year-old African American male with history of intermittent headaches presented to an outside hospital (OSH) with few days history of severe right lower extremity pain, swelling and dyspnea. Lower extremity venous ultrasound revealed a large occlusive deep vein thrombosis (DVT) extending from the right common femoral to the right popliteal vein. Chest Computed tomography angiogram (CT Angiogram) revealed a 5.9 cm mid ascending thoracic aortic aneurysm, a 3.2 cm pulmonary artery dilatation and no evidence of pulmonary embolus. He was started on anticoagulation with intravenous heparin and transferred to our institution for surgical management of the aortic aneurysm and evaluation for large vessel vasculitis.
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- 2021
15. Impact of Pulmonary Artery Dilatation on Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement
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Sung-Han Yoon, Wen Cheng, Vivek Patel, Keita Koseki, Raj Makkar, Mamoo Nakamura, Issei Komuro, Danon Kaewkes, Ofir Koren, and Tarun Chakravarty
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Atrial fibrillation ,Pulmonary artery dilatation ,medicine.disease ,Pulmonary hypertension ,Valve replacement ,Internal medicine ,medicine.artery ,Pulmonary artery ,medicine ,Clinical endpoint ,Cardiology ,In patient ,Cardiology and Cardiovascular Medicine ,business ,Kidney disease - Abstract
Objectives The aim of this study was to evaluate the clinical impact of computed tomography (CT)–derived pulmonary artery dilatation (PAD) in patients undergoing transcatheter aortic valve replacement (TAVR). Background Several studies have reported an association between pulmonary hypertension and cardiovascular events, but the prognostic value of PAD in patients undergoing TAVR remains unclear. Methods The preprocedural computed tomographic studies of patients who underwent TAVR at Cedars-Sinai Medical Center between November 2013 and December 2017 were analyzed. Patients were divided into 2 groups according to the presence of PAD assessed on CT (pulmonary artery [PA] diameter ≥29 mm). The primary endpoint was all-cause mortality at 2 years. Results A total of 895 patients were included (mean age 81.3 ± 8.5 years), with a mean Society of Thoracic Surgeons score of 4.8%. The median PA diameter was 28.0 mm, and PAD was observed in 369 patients (41.2%). Compared with the no-PAD group, the PAD group had higher Society of Thoracic Surgeons scores and higher rates of atrial fibrillation, chronic kidney disease, and chronic obstructive pulmonary disease. The PAD group had higher 2-year all-cause mortality than the no-PAD group (28.9% vs 12.8%; P 36 mm Hg). Conclusions CT-derived PAD is a significant prognostic factor in patients undergoing TAVR.
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- 2021
16. Obstructive lung disease secondary to compression of the bronchus by an enlarged pulmonary artery.
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Panthappattu, Justin, Sharma, Vidhu, Verma, Sameer, and Talwar, Arunabh
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OBSTRUCTIVE lung diseases , *PULMONARY artery , *BRONCHI , *PULMONARY hypertension , *LEAD tree - Abstract
In clinical practice, the presence of wheezing generally indicates an airway disease. In rare circumstances, adjacent mediastinal structures may compress the tracheobronchial tree leading to obstructive physiology. Compression of the tracheobronchial region by an enlarged pulmonary artery (PA) is exceedingly rare. We present here a case of pulmonary hypertension, where the enlarged PA resulted in obstructive lung physiology with a relevant review of the literature. [ABSTRACT FROM AUTHOR]
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- 2020
- Full Text
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17. The Pulmonary Artery in Pediatric Patients with Marfan Syndrome: An Underestimated Aspect of the Disease.
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Stark, Veronika C., Huemmer, Michael, Olfe, Jakob, Mueller, Goetz C., Kozlik-Feldmann, Rainer, and Mir, Thomas S.
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PULMONARY artery abnormalities , *MARFAN syndrome , *HEART failure patients , *CONGENITAL heart disease , *ELECTROCARDIOGRAPHY , *PREVENTION - Abstract
Aortic root dilatation and its complications are known to be the most important and life limiting features in patients with Marfan syndrome (MFS). Since monitoring of patients, preventive medical and surgical treatments are available nowadays, other MFS pathologies are becoming more relevant for the outcome of the disease. Main pulmonary artery (MPA) dilatation is a cardiac finding, which has not been fully investigated in children. Due to the similarities in tissue composition of the aortic and pulmonary root, MPA dilatation may cause complications and require treatment. In addition, it may be a predictor for severe connective tissue involvement. We retrospectively examined 135 pediatric patients with MFS. 8.1% showed MPA dilatation. MPA dilatation was associated with earlier occurrence of aortic dilatation, mitral valve prolapse, and systemic manifestations of MFS compared with patients without MPA dilatation (p < 0.05). The presence of MPA dilatation was also associated with a higher incidence of ectopia lentis (p < 0.05). Medical treatment was started earlier in MPA dilatation patients than in those without (p < 0.05). We conclude that MPA dilatation is a sign of more severe vascular and connective tissue involvement. Regular examination of the pulmonary artery is essential in MFS to avoid complications. As medical treatment of life threatening MFS events has improved, other features of MFS need to be investigated to improve quality of life. [ABSTRACT FROM AUTHOR]
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- 2018
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18. The dilatation of main pulmonary artery and right ventricle observed by enhanced chest computed tomography predict poor outcome in inoperable chronic thromboembolic pulmonary hypertension.
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Ema, Ryogo, Sugiura, Toshihiko, Kawata, Naoko, Tanabe, Nobuhiro, Kasai, Hajime, Nishimura, Rintaro, Jujo, Takayuki, Shigeta, Ayako, Sakao, Seiichiro, and Tatsumi, Koichiro
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PULMONARY hypertension diagnosis , *CHEST examination , *COMPUTED tomography , *THROMBOEMBOLISM , *HEART dilatation - Abstract
Background: Dilatation of the pulmonary artery and right ventricle on chest computed tomography images is often observed in patients with pulmonary hypertension. The clinical significance of these image findings has not been defined in chronic thromboembolic pulmonary hypertension. We investigated whether the pulmonary arterial and right ventricle dilatation was associated with poor outcome in chronic thromboembolic pulmonary hypertension.Methods: This was a retrospective cohort investigation in 60 subjects with inoperable chronic thromboembolic pulmonary hypertension diagnosed consecutively between 1997 and 2010 at Chiba University Hospital. Digital scout multi-detector chest computed tomography images were obtained. The main pulmonary arterial to ascending aortic diameter ratio and the right ventricular to left ventricular diameter ratio were calculated.Results: Main pulmonary arterial to ascending aortic diameter ratio ranged from 0.85 to 1.84, and right ventricular to left ventricular diameter ratio ranged from 0.71 to 2.88. During the observation period of 1284.5days (range, 21-4550days), 13 patients required hospitalization due to worsening; 6 of them died. Kaplan-Meier analysis showed significant differences in hospitalization between the patients with main pulmonary arterial to ascending aortic diameter ratio of ≥1.1 and <1.1 (log-rank test, p=0.014) and between the patients with right ventricular to left ventricular diameter ratio of ≥1.2 and <1.2 (log-rank test, p=0.013). There was a significant difference in the prognosis between the patients with RV/LV ratio≥1.2 and those with RV/LV ratio<1.2 (log-rank test, p=0.033).Conclusions: Main pulmonary arterial to ascending aortic diameter ratio measured using enhanced CT images was associated with the risk for first clinical exacerbation, and right ventricular to left ventricular diameter ratio was associated with the risk for poor prognosis in inoperable chronic thromboembolic pulmonary hypertension. [ABSTRACT FROM AUTHOR]- Published
- 2017
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19. Massive Pulmonary Artery Dilatation in a Case of Chronic Thromboembolic Pulmonary Hypertension.
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Miles, Jeremy A., Wan, Ningxin, and Murthy, Sandhya
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PULMONARY artery , *SYNCOPE , *PULMONARY embolism , *PULMONARY hypertension diagnosis , *ARTERIAL dilatation - Published
- 2019
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20. The outcome of pulmonary hypertension and its association with pulmonary artery dilatation
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A. L. Duijnhouwer, J. Lemmers, J. Smit, J. van Haren-Willems, H. Knaapen-Hans, T. ten Cate, W. Hagmolen of ten Have, M.-J. de Boer, J. Roos-Hesselink, M. Vonk, A. van Dijk, and Cardiology
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medicine.medical_specialty ,medicine.drug_class ,Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] ,030204 cardiovascular system & hematology ,New york heart association ,Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] ,03 medical and health sciences ,Walking distance ,0302 clinical medicine ,Internal medicine ,medicine.artery ,medicine ,Natriuretic peptide ,Outpatient clinic ,Stage (cooking) ,business.industry ,Pulmonary ,Pulmonary artery dilatation ,medicine.disease ,Dilatation ,Pulmonary hypertension ,Pulmonary artery ,030228 respiratory system ,Hypertension ,Inflammatory diseases Radboud Institute for Health Sciences [Radboudumc 5] ,Cardiology ,Original Article ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Pulmonary artery (PA) dilatation is often seen in pulmonary hypertension (PH) and is considered a long-term consequence of elevated pressure. The PA dilates over time and therefore may reflect disease severity and duration. Survival is related to the stage of the disease at the time of diagnosis and therefore PA diameter might be used to predict prognosis. This study evaluates the outcome of patients with pulmonary arterial hypertension (PAH) and chronic thrombo-embolic pulmonary hypertension (CTEPH) and investigates whether PA diameter at the time of diagnosis is associated with mortality. Methods Patients visiting an outpatient clinic of a tertiary centre between 2004 and 2018 with a cardiac catheterisation confirmed diagnosis of PAH or CTEPH and a CT scan available for PA diameter measurement were included. PA diameter and established predictors of survival were collected (New York Heart Association (NYHA) class, N‑terminal pro-brain natriuretic peptide (NT-proBNP) level and 6‑min walking distance (6MWD)). Results In total 217 patients were included (69% female, 71% NYHA class ≥III). During a median follow-up of 50 (22–92) months, 54% of the patients died. Overall survival was 87% at 1 year, 70% at 3 years and 58% at 5 years. The mean PA diameter was 34.2 ± 6.2 mm and was not significantly different among all the diagnosis groups. We found a weak correlation between PA diameter and mean PA pressure ( r = 0.23, p Conclusion The prognosis of PAH and CTEPH is still poor. Known predictors of survival were confirmed, but PA diameter at diagnosis was not associated with survival in PAH or CTEPH patients.
- Published
- 2020
21. Is a Fetal Echocardiography Necessary in <scp>IVF‐ICSI</scp> Pregnancies After Anatomic Survey?
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Angela C. Ranzini and Oluyemi A. Aderibigbe
- Subjects
Adult ,Heart Defects, Congenital ,Heart Septal Defects, Ventricular ,medicine.medical_specialty ,medicine.medical_treatment ,Population ,030204 cardiovascular system & hematology ,Ultrasonography, Prenatal ,Intracytoplasmic sperm injection ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Surveys and Questionnaires ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Sperm Injections, Intracytoplasmic ,cardiovascular diseases ,education ,Retrospective Studies ,Fetus ,education.field_of_study ,In vitro fertilisation ,medicine.diagnostic_test ,business.industry ,Heart ,Pulmonary artery dilatation ,Ivf icsi ,Increased risk ,Echocardiography ,cardiovascular system ,Cardiology ,Female ,business ,Fetal echocardiography - Abstract
Purpose In vitro fertilization with intracytoplasmic sperm injection (IVF-ICSI) is generally regarded as an indication for fetal echocardiography due to a reported increased risk of congenital abnormalities including cardiac anomalies. In this study we evaluated the utility of fetal echocardiography after anatomic survey in an experienced center. Methods This was a retrospective case review of in vitro fertilization with intracytoplasmic sperm injection pregnancies who had echocardiography in our institution from January 1996 to October 2010. Results Records from 85 mothers and 110 fetuses were identified. During anatomic survey, six cardiac anomalies were identified, including four ventricular septal defects, one pulmonary-aortic disproportion, and one post-valvular pulmonary artery dilatation. At fetal echocardiography, two of the four ventricular septal defects were confirmed and an additional three were identified. The most common cardiac anomaly seen in our population of IVF-ICSI pregnancies was ventricular septal defect, which was identified in 3.6% of all cases in the neonatal period. Of ventricular septal defects identified in the prenatal period, 71% resolved before birth. Conclusion In experienced centers, a fetal echocardiography may not be necessary if the 3 vessels tracheal view of the heart is evaluated and the heart is evaluated carefully for a ventricular septal defect.
- Published
- 2020
22. Pulmonary Arterial Dilatation: Imaging Evaluation Using Multidetector Computed Tomography
- Author
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Arun Sharma, Siddharthan Deepti, Niraj Nirmal Pandey, Sanjeev Kumar, Sreenivasa Narayana Raju, and Amarinder Singh Malhi
- Subjects
medicine.medical_specialty ,business.industry ,R895-920 ,Context (language use) ,Review Article ,Pulmonary artery dilatation ,medicine.disease ,vasculitis ,Review article ,Medical physics. Medical radiology. Nuclear medicine ,medicine.anatomical_structure ,medicine.artery ,pulmonary artery dilatation ,pulmonary arterial hypertension ,Pulmonary artery ,cardiac shunt ,medicine ,Etiology ,Radiology, Nuclear Medicine and imaging ,pulmonary thromboembolism ,Radiology ,business ,Vasculitis ,Radiation treatment planning ,Artery - Abstract
Pulmonary artery dilatation comprises a heterogeneous group of disorders. Early diagnosis is important as the presentation may be incidental, chronic, or acute and life threatening depending upon the etiology. Cross-sectional imaging plays an important role, with CT pulmonary angiography being regarded as the first line investigation in the evaluation of pulmonary artery pathologies. Moreover, effects of pulmonary artery lesions on proximal and distal circulation can also be ascertained with the detection of associated conditions. Special attention should also be given to the left main coronary artery and the trachea-bronchial tree as they may be extrinsically compressed by the dilated pulmonary artery. In context of an appropriate clinical background, CT pulmonary angiography also helps in treatment planning, prognostication, and follow-up of these patients. This review mainly deals with imaging evaluation of the pulmonary arterial dilatations on CT with emphasis on the gamut of etiologies in the adult as well as pediatric populations.
- Published
- 2021
23. Obstructive lung disease secondary to compression of the bronchus by an enlarged pulmonary artery
- Author
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Sameer Verma, Arunabh Talwar, Vidhu Sharma, and Justin Panthappattu
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Case Report ,Respiratory physiology ,intrathoracic obstruction ,03 medical and health sciences ,0302 clinical medicine ,pulmonary hypertension ,Medicine ,obstructive lung disease ,030212 general & internal medicine ,lcsh:RC705-779 ,Bronchus ,business.industry ,Pulmonary artery dilatation ,lcsh:Diseases of the respiratory system ,medicine.disease ,Pulmonary hypertension ,Obstructive lung disease ,Clinical Practice ,medicine.anatomical_structure ,Airway disease ,030228 respiratory system ,Enlarged pulmonary artery ,pulmonary artery dilatation ,bronchial compression ,Radiology ,business - Abstract
In clinical practice, the presence of wheezing generally indicates an airway disease. In rare circumstances, adjacent mediastinal structures may compress the tracheobronchial tree leading to obstructive physiology. Compression of the tracheobronchial region by an enlarged pulmonary artery (PA) is exceedingly rare. We present here a case of pulmonary hypertension, where the enlarged PA resulted in obstructive lung physiology with a relevant review of the literature.
- Published
- 2020
24. Unenhanced multidetector computed tomography findings in acute central pulmonary embolism
- Author
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Chee Wai Mak, Chia-Hui Chen, Chiao-Hsuan Chien, Wan-Ling Wu, Fu-Chieh Shih, and Chin-Yu Chen
- Subjects
Male ,lcsh:Medical technology ,Computed Tomography Angiography ,Contrast Media ,Pulmonary Artery ,Sensitivity and Specificity ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,medicine.artery ,Multidetector Computed Tomography ,Multidetector computed tomography ,Pulmonary angiography ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,In patient ,cardiovascular diseases ,CTPA ,Aged ,Retrospective Studies ,Aged, 80 and over ,Receiver operating characteristic ,business.industry ,High attenuation ,Area under the curve ,Middle Aged ,medicine.disease ,Imaging analysis ,Pulmonary embolism ,Wedge-shaped consolidation ,ROC Curve ,lcsh:R855-855.5 ,Area Under Curve ,Pulmonary artery ,cardiovascular system ,Radiographic Image Interpretation, Computer-Assisted ,Female ,Pulmonary artery dilatation ,Pulmonary Embolism ,business ,Nuclear medicine ,030217 neurology & neurosurgery ,Research Article - Abstract
Background Computed tomography pulmonary angiography (CTPA) is the gold standard for the diagnosis of pulmonary embolism (PE). However, contrast is contraindicated in some patients. The purpose of this study was to determine the diagnostic accuracy of unenhanced multidetector CT (MDCT) for diagnosis of central PE using CTPA as the gold standard. Methods The records of patients with suspected PE seen between 2010 and 2013 were retrospectively reviewed. Inclusion criteria were an acute, central PE confirmed by CTPA and non-enhanced MDCT before contrast injection. Patients with a PE ruled out by CTPA served as a control group. MDCT findings studied were high-attenuation emboli in pulmonary artery (PA), main PA dilatation > 33.2 mm, and peripheral wedge-shaped consolidation. Receiver operating characteristic (ROC) analysis was used to determine the sensitivity and specificity of unenhanced MDCT to detect PE. Wells score of all patients were calculated using data extracted from medical records prior to imaging analysis. Results Thirty-two patients with a PE confirmed by CTPA and 32 with a PE ruled out by CTPA were included. Among the three main MDCT findings, high-attenuation emboli in the PA showed best diagnostic performance (Sensitivity 72.9%; Specificity 100%), followed by main PA dilatation > 33.2 mm (sensitivity 46.9%; specificity 90.6%), and peripheral wedge-shaped consolidation (sensitivity 43.8%; specificity 78.1%). Given any one or more positive findings on unenhanced MDCT, the sensitivity was 96.9% and specificity was 71.9% for a diagnosis of PE in patients. The area under the curve (AUC) of a composite measure of unenhanced MDCT findings (0.909) was significantly higher than that of the Wells score (0.688), indicating unenhanced MDCT was reliable for detecting PE than Wells score. Conclusions Unenhanced MDCT is an alternative for the diagnosis of acute central PE when CTPA is not available.
- Published
- 2019
25. Aortic and left pulmonary artery dilatation: an unusual cause of a left hilar mass and lung collapse
- Author
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Adenike Temitayo Adeniji-Sofoluwe and Atiku Hafiz
- Subjects
pulmonary artery dilatation ,lung collapse ,aorta ,Medicine - Abstract
An 80 year old clergy, presented with a 5-day history of left-sided chest pain which was non-radiating but had cough productive of white sputum. No history of haemoptysis, dyspnoea, orthopnoea or paroxysmal nocturnal dyspnoea was elicited. However, a history of smoking 2 cigarettes per day for 10 years was present. He is a known hypertensive on medications,also being managed for diverticulosis and Benign Prostatic Hypertrophy.Respiratory rate was 26cycles per minute with crepitations in the left mid-and lower lung zones. Bilateral pedal oedema was found but the cardiovascular and gastrointestinal systems were normal. Requests for an ultrasound, a chest X-rayCXR and Contrast Enhanced computerised tomography CECT of the chest were made. High resolution CECT of the chest was performed with a 64-slice Toshiba CT. Multiplanar images in axial, coronal and sagittal planes were acquired at 1mm cuts in pre-and post-contrast series. Images depicting the abnormality are shown (A, B, C,D). No further invasive workup like a biopsy was indicated following imaging. Prior to the CECT, bronchogenic CA was considered in view of the long standing smoking history. The role of Computerised tomography in the evaluation of chest symptoms has been emphasised in these images.
- Published
- 2014
- Full Text
- View/download PDF
26. Surgical management of aortopulmonary window with pulmonary artery dilatation causing left main coronary compression
- Author
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Vidur Bansal, Sanjeev Naganur, Anand Kumar Mishra, and Pratyaksha Rana
- Subjects
Male ,medicine.medical_specialty ,Pulmonary Circulation ,Adolescent ,Pulmonary Artery ,Chest pain ,Extrinsic compression ,Aortopulmonary window ,Aortopulmonary Septal Defect ,Sudden cardiac death ,Internal medicine ,medicine ,Humans ,business.industry ,Heart ,General Medicine ,Pulmonary artery dilatation ,medicine.disease ,Pulmonary hypertension ,Dilatation ,medicine.anatomical_structure ,Pediatrics, Perinatology and Child Health ,Cardiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,Complication ,business ,Artery - Abstract
Aortopulmonary window is a rare congenital heart defect. Left main coronary artery extrinsic compression by an enlarged pulmonary artery is a rare complication and a potential cause for chest pain and sudden cardiac death in patients with pulmonary hypertension. Here, we present the case of a 14-year-old boy with a large aortopulmonary window who was planned for a device closure, but during the procedure, he developed ST-T segment changes while the device was being deployed, and hence the procedure was abandoned. The boy subsequently underwent a successful surgical closure thereafter.
- Published
- 2021
27. Pulmonary Artery Dilatation Is a Common Finding in a Coronary Artery CT Angiography Population
- Author
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Timo Liimatainen, Miika Korhonen, Ritva Vanninen, Juska Vienonen, Johannes Parkkonen, Marja Hedman, and S. Petteri Kauhanen
- Subjects
Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Computed Tomography Angiography ,Population ,Pulmonary Artery ,Coronary Angiography ,General Biochemistry, Genetics and Molecular Biology ,Framingham Heart Study ,Internal medicine ,medicine.artery ,medicine ,Humans ,education ,Pharmacology ,Body surface area ,education.field_of_study ,medicine.diagnostic_test ,business.industry ,Pulmonary artery dilatation ,Middle Aged ,Coronary Vessels ,Dilatation ,medicine.anatomical_structure ,Angiography ,Pulmonary artery ,Cardiology ,Population study ,Female ,business ,Artery ,Research Article - Abstract
Background/Aim: Dilatation of the main pulmonary artery (mPA) is a common incidental finding in chest imaging and often leads to consultation. The aim of this study was to determine the prevalence of mPA dilatation in a coronary artery CT angiography (CCTA) population. Patients and Methods: The study investigated 985 consecutive patients scheduled for diagnostic CCTA. The transverse axial diameter of the mPA was measured. The prevalence of mPA dilatation was estimated using different reference values (Framingham Heart Study: 28.9 mm for males and 26.9 mm for females, Bozlar: 29.5 mm for both genders and Karazincir: 32.6 mm for males and 31.9 mm for females). Results: The patient mean age was 53.0±9.7 years (66.5% were women). Body surface area (BSA) correlated moderately with the mPA diameter (r=0.423, p
- Published
- 2021
28. Pulmonary artery aneurysm in an adult patient with idiopathic dilatation of the pulmonary artery.
- Author
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Betkier-Lipińska, Katarzyna, Suwalski, Grzegorz, Czarkowski, Sebastian, Hendzel, Piotr, and Cwetsch, Andrzej
- Subjects
- *
HEART dilatation ,PULMONARY artery diseases ,HEART disease research - Abstract
Idiopathic dilatation of the pulmonary artery (IDPA) is a rare congenital heart disease. It has been described for almost one hundred years, and numerous definitions have been proposed. The IDPA diagnostic criteria have not been updated for years. Secondary to primary disease, pulmonary artery aneurism was recognised as a lethal defect; however, long-term follow-up of patients with IDPA has not been well researched. Thus, indications to medical or surgical treatment are not evidence based. Here, we present a rare case of a 54-year-old patient with IDPA, who remained under observation for 36 years without surgical intervention. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
29. Successful Surgical Management of Aortopulmonary window with Severe Pulmonary Artery Dilatation causing compression of Left Main Coronary Artery in an Adolescent
- Author
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Vidur Bansal, Anand Kumar Mishra, Pratyaksha Rana, Vinay Upadhyay, Parag Barwad, Ruchit Patel, and Sanjeev Naganur
- Subjects
medicine.medical_specialty ,business.industry ,Pulmonary artery dilatation ,medicine.disease ,Chest pain ,Pulmonary hypertension ,Aortopulmonary window ,Sudden cardiac death ,medicine.anatomical_structure ,Internal medicine ,medicine.artery ,Pulmonary artery ,Cardiology ,medicine ,medicine.symptom ,Complication ,business ,Artery - Abstract
Aortopulmonary Window is a rare congenital heart defect comprising 0.1-0.2% of the total spectrum. Spontaneous closure of this defect is unknown and survival into childhood and adult life is rarely seen. Severe pulmonary artery hypertension develops and causes dilatation of the pulmonary artery. Left main coronary artery extrinsic compression by an enlarged pulmonary artery is a rare complication and a potential cause for chest pain and sudden cardiac death in patients with pulmonary hypertension.
- Published
- 2020
30. Pulmonary artery dilatation and obstructive sleep apnea
- Author
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Harley Greenberg, Arunabh Talwar, and Joseph Simonson
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Sleep Apnea, Obstructive ,business.industry ,Hypertension, Pulmonary ,Sleep apnea ,Pulmonary artery dilatation ,medicine.disease ,Sleep in non-human animals ,Scleroderma ,Obstructive sleep apnea ,03 medical and health sciences ,0302 clinical medicine ,Sleep Apnea Syndromes ,030228 respiratory system ,Neurology ,Sleep apnea syndromes ,Internal medicine ,medicine ,Cardiology ,Humans ,Neurology (clinical) ,business ,Letters to the Editor ,030217 neurology & neurosurgery - Abstract
CITATIONSimonson J, Greenberg H, Talwar A. Pulmonary artery dilatation and obstructive sleep apnea. J Clin Sleep Med. 2020;16(4):647.
- Published
- 2020
31. Severe dilatation of the pulmonary artery at the presentation of idiopathic pulmonary hypertension - case report
- Author
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Nasri, Narcisse, Nasri, Sara Soraja, and Pavliša, Gordana
- Subjects
idiopathic pulmonary hypertension ,pulmonary artery dilatation ,truncus pulmonalis - Abstract
Idiopathic pulmonary hypertension (PH) is a rare disease defined by the mean artery pulmonary pressure (mPAP) of at least 25 mmHg, pulmonary artery wedge pressure ≤ 15 mmHg and a pulmonary vascular resistance > 3 Wood units in the absence of other causes of precapillary pulmonary hypertension. Pulmonary artery (PA) dilation is a common finding in PH, but only a small proportion of patients with PH had a diameter >40 mm. We present a patient with a severe PA dilatation already at the time of diagnosis.
- Published
- 2020
32. Acute and chronic dissection of pulmonary artery: new challenges in pulmonary arterial hypertension?
- Author
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Joanna Pepke-Żaba, Maria Wieteska, Adam Torbicki, Marcin Kurzyna, Piotr Gościniak, Michał Florczyk, and Andrzej Biederman
- Subjects
Pulmonary and Respiratory Medicine ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,Case Report ,Dissection (medical) ,030204 cardiovascular system & hematology ,Pulmonary arterial hypertension ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine.artery ,medicine ,In patient ,Pulmonary artery dissection ,lcsh:RC705-779 ,business.industry ,lcsh:Diseases of the respiratory system ,Pulmonary artery dilatation ,medicine.disease ,030228 respiratory system ,lcsh:RC666-701 ,Warning signs ,pulmonary artery dilatation ,Pulmonary artery ,Cardiology ,Right ventricular failure ,business ,pulmonary artery dissection - Abstract
Right ventricular failure is a leading cause of mortality in patients with pulmonary arterial hypertension (PAH). However, up to 25% of such patients die unexpectedly, without warning signs of hemodynamical decompensation. We previously documented that pulmonary artery (PA) dilatation significantly increases the risk of those deaths. Some of them may be due to dissection of PA resulting in cardiac tamponade. However, direct confirmation of this mechanism is difficult as most of such deaths occur outside hospitals. We present 4 patients with severe PAH and PA dilatation in whom PA dissection has been confirmed. Three patients had IPAH, one had PAH associated with congenital heart disease. All patients had mean pulmonary artery pressure (PAP) > 50 mmHg at diagnosis and dissection occurred late in the course of apparently well controlled disease (6 to 14 years). Several clinical elements were common to our patients - high systolic PAP, long lasting PH, progressive dilatation of PA to more than 50 mm with chest pain prior to dissection. However, clinical course followed three different patterns: sudden death due to cardiac tamponade, hemopericarditis caused by blood leaking from dissected aneurysm with imminent but not immediate cardiac tamponade, or chronic asymptomatic PA dissection. Indeed, two of our patients are alive and on lung transplantation waiting list for more than 2 years now. Further research is needed to suggest optimal management strategies for patients with stable PAH but significantly dilated proximal pulmonary arteries or confirmed PA dissection depending on the clinical presentation and expected outcome.
- Published
- 2018
33. Aortic and pulmonary artery dilatation in Cantu syndrome: expanding the phenotype
- Author
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Ching-Kit Chen, Saumya Shekhar Jamuar, Angeline Hm Lai, Oon-Hoe Teoh, Yi-Rong Chew, Roger Foo, and Jiin Ying Lim
- Subjects
Heart Defects, Congenital ,Cantú syndrome ,medicine.medical_specialty ,Hypertrichosis ,Cardiomegaly ,Pulmonary Artery ,Osteochondrodysplasias ,Pathology and Forensic Medicine ,Internal medicine ,medicine ,Humans ,Child ,Aorta ,Genetics (clinical) ,business.industry ,General Medicine ,Pulmonary artery dilatation ,medicine.disease ,Dilatation ,Phenotype ,Pediatrics, Perinatology and Child Health ,Cardiology ,Female ,Anatomy ,business ,Dilatation, Pathologic - Published
- 2019
34. Unenhanced multidetector computed tomography findings in acute central pulmonary embolism
- Author
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Chien, Chiao-Hsuan, Shih, Fu-Chieh, Chen, Chin-Yu, Chen, Chia-Hui, Wu, Wan-Ling, and Mak, Chee-Wai
- Published
- 2019
- Full Text
- View/download PDF
35. Pulmonary Arterial Dilatation in Pulmonary Hypertension: Prevalence and Prognostic Relevance.
- Author
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Badagliacca, Roberto, Poscia, Roberto, Pezzuto, Beatrice, Papa, Silvia, Nona, Alfred, Mancone, Massimo, Mezzapesa, Mario, Nocioni, Martina, Sciomer, Susanna, Valli, Gabriele, Cedrone, Nadia, Fedele, Francesco, and Vizza, Carmine Dario
- Subjects
- *
PULMONARY hypertension , *PULMONARY artery abnormalities , *HEMODYNAMICS , *DISEASE prevalence , *TOMOGRAPHY , *UNIVARIATE analysis , *PHYSIOLOGY - Abstract
Objectives: Pulmonary arterial dilatation is considered a consequence of chronic pulmonary hypertension (PH), but despite its relatively common detection, its prevalence and prognostic impact have not yet been systematically investigated. The aim of the study was to investigate these factors in a relatively large cohort of severe PH patients. Methods: One hundred and forty-one consecutive patients diagnosed with PH were monitored for a mean of 957 days. Data including functional class, exercise capacity, invasive hemodynamics and pulmonary artery (PA) echo/CT scan measurement were performed and outcomes prospectively collected. Results: PA dilatation is a common feature, present in the 76.6% of cases in this cohort of severe PH patients. Survival at 1, 2 and 3 years was 83, 71 and 58%, respectively. On univariate analysis, the baseline variables associated with a poor outcome were related to pulmonary arterial hypertension associated with connective tissue disease (CDT-PAH), New York Heart Association (NYHA) functional class, 6-min walk test and right atrial pressure. On multivariate analysis only CDT-PAH and NYHA functional class remained independently associated with poor survival. Conclusions: PA dilatation is commonly detected in severe PH patients and is not associated with an increased risk of death. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
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36. Clinical and postmortem findings of pentalogy of Fallot in an 18-month-old Holstein heifer
- Author
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Makoto Uchida, Fuko Matsuda, Yoshihiro Nakamura, Kazuyuki Uchida, James K. Chambers, Eiji Makino, Dai Ishiyama, and Yukio Onodera
- Subjects
Heart Defects, Congenital ,medicine.medical_specialty ,congenital, hereditary, and neonatal diseases and abnormalities ,Holstein Cattle ,animal structures ,Aortic root ,animal diseases ,Cattle Diseases ,Anorexia ,Fatal Outcome ,Right ventricular hypertrophy ,Internal medicine ,Ductus arteriosus ,medicine ,Internal Medicine ,Ventricular outflow tract ,Animals ,cardiovascular diseases ,postmortem examination ,Recent onset ,pentalogy of Fallot ,General Veterinary ,business.industry ,Pulmonary artery dilatation ,medicine.disease ,Note ,congenital heart disease ,medicine.anatomical_structure ,Cardiology ,cardiovascular system ,Cattle ,Female ,medicine.symptom ,business ,Holstein Friesian heifer - Abstract
An 18-month-old female Holstein Friesian heifer presented with a history of stunted growth and a recent onset of anorexia; she presented with cyanosis and eventually died. A postmortem examination revealed obstruction of the right ventricular outflow tract, ventricular septal defect, overriding aortic root, right ventricular hypertrophy, and an atrial septal defect, indicating a pentalogy of Fallot (POF). In addition to POF, the heifer also had pulmonary artery dilatation, although she did not present with patent ductus arteriosus. This heifer had the longest lifespan among the Holstein cattle reported to have POF, which may be secondary to delayed pulmonary obstruction due to deformation of one of the pulmonary valves.
- Published
- 2019
37. Massive Pulmonary Artery Dilatation in a Case of Chronic Thromboembolic Pulmonary Hypertension
- Author
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Ningxin Wan, Jeremy Miles, and Sandhya Murthy
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,biology ,business.industry ,Computed Tomography Angiography ,Hypertension, Pulmonary ,Syncope (genus) ,General Medicine ,Pulmonary artery dilatation ,Middle Aged ,Pulmonary Artery ,biology.organism_classification ,Pulmonary Valve Insufficiency ,Syncope ,Echocardiography ,Internal medicine ,Cardiology ,Medicine ,Humans ,Chronic thromboembolic pulmonary hypertension ,Female ,business ,Pulmonary Embolism ,Computed tomography angiography ,Dilatation, Pathologic - Published
- 2019
38. Fallot Tetralogy with Dissected Pulmonary Artery Aneurysm: A Rare Case Report
- Author
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Gaurav Rajbhandari, Sheng Li, You-en Zhang, Bing Wu, and Hu-nian Li
- Subjects
Pulmonary artery aneurysm ,medicine.medical_specialty ,business.industry ,General Medicine ,Disease ,Pulmonary artery dilatation ,Dissection (medical) ,medicine.disease ,Pulmonary hypertension ,Internal medicine ,Rare case ,Cardiology ,Medicine ,Surgery ,Pulmonary artery dissection ,Tetralogy ,Cardiology and Cardiovascular Medicine ,business - Abstract
Pulmonary artery dissection is a rare and extremely dangerous disease with high mortality rates. It is one of the most serious complications of chronic pulmonary hypertension. It may be related to chronic pulmonary hypertension and pulmonary artery dilatation. Early diagnosis of pulmonary dissection is particularly important because of its high mortality. Once the symptoms worsen or severe deterioration of the disease occurs, imaging examination should be performed promptly for early diagnosis and timely treatment.
- Published
- 2020
39. PULMONARY ARTERY DILATATION IN ASYMPTOMATIC YOUNG MALES
- Author
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Rahul Bhardwaj, Seyed Kamran Hejazi Kenari, Ahmet Copur, and Eric Shafer
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,Cardiology ,Pulmonary artery dilatation ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,Critical Care and Intensive Care Medicine ,business ,Asymptomatic ,Young male - Published
- 2020
40. Pulmonary artery dilatation in congenital heart disease: Size doesn't matter
- Author
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Matthias Greutmann, University of Zurich, and Greutmann, Matthias
- Subjects
Adult ,Heart Defects, Congenital ,medicine.medical_specialty ,Heart disease ,business.industry ,610 Medicine & health ,Pulmonary artery dilatation ,Pulmonary Artery ,medicine.disease ,Prognosis ,Aneurysm ,Dilatation ,2705 Cardiology and Cardiovascular Medicine ,Internal medicine ,10209 Clinic for Cardiology ,Cardiology ,Prevalence ,Medicine ,Humans ,Cardiology and Cardiovascular Medicine ,business - Published
- 2018
41. Pulmonary artery aneurysm in an adult patient with idiopathic dilatation of the pulmonary artery
- Author
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Grzegorz Suwalski, Piotr Hendzel, Katarzyna Betkier-Lipińska, Andrzej Cwetsch, and Sebastian Czarkowski
- Subjects
Pulmonary artery aneurysm ,medicine.medical_specialty ,Heart disease ,business.industry ,Case Report ,Pulmonary artery dilatation ,Primary disease ,medicine.disease ,main pulmonary artery ,Main Pulmonary Artery ,Surgery ,pulmonary artery dilatation ,medicine.artery ,Internal medicine ,Pulmonary artery ,Rare case ,Cardiology ,medicine ,Cardiology and Cardiovascular Medicine ,business ,Surgical treatment - Abstract
Idiopathic dilatation of the pulmonary artery (IDPA) is a rare congenital heart disease. It has been described for almost one hundred years, and numerous definitions have been proposed. The IDPA diagnostic criteria have not been updated for years. Secondary to primary disease, pulmonary artery aneurism was recognised as a lethal defect; however, long-term follow-up of patients with IDPA has not been well researched. Thus, indications to medical or surgical treatment are not evidence based. Here, we present a rare case of a 54-year-old patient with IDPA, who remained under observation for 36 years without surgical intervention.
- Published
- 2015
42. Progression of pulmonary artery dilatation in patients with pulmonary hypertension coexisting with a pulmonary artery aneurysm
- Author
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Shingo Kasahara, Kentaro Ejiri, Kazufumi Nakamura, Hiroshi Ito, Satoshi Akagi, and Toshihiro Sarashina
- Subjects
Adult ,Heart Defects, Congenital ,Male ,medicine.medical_specialty ,Adolescent ,Hypertension, Pulmonary ,Computed tomography ,030204 cardiovascular system & hematology ,Pulmonary Artery ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Aneurysm ,Predictive Value of Tests ,Risk Factors ,medicine.artery ,Internal medicine ,medicine ,Humans ,In patient ,cardiovascular diseases ,Pulmonary artery aneurysm ,medicine.diagnostic_test ,business.industry ,Pulmonary artery dilatation ,Middle Aged ,medicine.disease ,Pulmonary hypertension ,Dilatation ,Treatment Outcome ,030228 respiratory system ,Predictive value of tests ,Pulmonary artery ,cardiovascular system ,Cardiology ,Disease Progression ,Female ,Cardiology and Cardiovascular Medicine ,business ,Tomography, X-Ray Computed ,Dilatation, Pathologic ,Follow-Up Studies - Abstract
Background Pulmonary artery (PA) dilatation is usually observed in patients with pulmonary hypertension (PH), but a PA aneurysm (PA diameter > 40 mm) is rare. The difference between characteristics of patients with and those without progression of PA diameter remains poorly understood. We assessed the changes in PA diameter in patients with PH coexisting with and without a PA aneurysm. Methods We investigated the changes in PA diameter by multi-detector computed tomography performed twice with an interval of more than one year in 44 patients with PH. Seventeen patients had a PA aneurysm and 27 patients did not have a PA aneurysm at baseline. Results The median follow-up period was 3.6 years. All patients received medical or invasive treatment for PH. At baseline, main PA diameters were 52 ± 15 mm in patients with a PA aneurysm and 33 ± 3 mm in patients without a PA aneurysm. Mean PA pressure was higher in patients with a PA aneurysm than in those without a PA aneurysm (61 ± 15 mmHg vs. 51 ± 16 mmHg, p = 0.04). At follow-up, mean PA pressure significantly decreased in both patients with a PA aneurysm (44 ± 11 mmHg) and patients without a PA aneurysm (41 ± 18 mmHg). Main PA diameter significantly increased in patients with a PA aneurysm (65 ± 28 mm, change ratio: 23.3%), while it did not increase in patients without a PA aneurysm (32 ± 3 mm, change ratio: −3.1%). Conclusions PA dilatation progressed in patients with a PA aneurysm despite treatment of PH. The progression of PA dilatation is independent of reduction of PA pressure by PH treatment.
- Published
- 2017
43. Multi-imaging assessment of successful surgical treatment of pulmonary artery dilatation and dissection in Marfan syndrome
- Author
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María Elena Soto, Nilda Espinola-Zavaleta, Virgilia Soto-Abraham, Valentin Herrera, and Sergio Criales-Vera
- Subjects
0301 basic medicine ,Marfan syndrome ,Adult ,Male ,medicine.medical_specialty ,Chest Pain ,Computed Tomography Angiography ,Magnetic Resonance Imaging, Cine ,Dissection (medical) ,Pulmonary Artery ,Multimodal Imaging ,Risk Assessment ,Severity of Illness Index ,Marfan Syndrome ,03 medical and health sciences ,Imaging, Three-Dimensional ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Surgical treatment ,business.industry ,Biopsy, Needle ,General Medicine ,Pulmonary artery dilatation ,medicine.disease ,Prognosis ,Immunohistochemistry ,Surgery ,030104 developmental biology ,Dyspnea ,Treatment Outcome ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Vascular Surgical Procedures ,Dilatation, Pathologic - Published
- 2016
44. IMAGE SECTION Section Editor: Ivan D'Cruz, M.D. Pectus Excavatum Associated with Pulmonary Artery Dilatation.
- Author
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D'Cruz, Ivan, Shirwany, Arsalan, and Gerlach, Paul
- Subjects
- *
PULMONARY artery , *TRANSESOPHAGEAL echocardiography , *ECHOCARDIOGRAPHY , *PATIENTS - Abstract
Presents a case study which described the association of pulmonary artery dilatation with pectus excavatum. Description of the patient; Findings of transthoracic echocardiography; Results of the transesophageal echocardiography.
- Published
- 2004
- Full Text
- View/download PDF
45. A Case of Extrinsic Compression of the Left Main Coronary Artery Secondary to Pulmonary Artery Dilatation
- Author
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Yoon Jung Choi, Jong-Seon Park, Won-Jong Park, Ung Kim, Dong-Gu Shin, Young Jo Kim, Sang-Hee Lee, and J.-H. Lee
- Subjects
medicine.medical_specialty ,Pulmonary Artery Dilatation ,medicine.medical_treatment ,Cardiovascular Disorders ,Hypertension, Pulmonary ,Case Report ,Pulmonary Artery ,Coronary Angiography ,Angina Pectoris ,Angina ,Ventricular Dysfunction, Left ,Percutaneous Coronary Intervention ,medicine.artery ,Internal medicine ,Medicine ,Humans ,Angioplasty, Balloon, Coronary ,Coronary Arteries ,Ultrasonography ,business.industry ,Coronary Stenosis ,Percutaneous coronary intervention ,Stent ,General Medicine ,Pulmonary artery dilatation ,Middle Aged ,medicine.disease ,Pulmonary hypertension ,Coronary Vessels ,Coronary arteries ,medicine.anatomical_structure ,Pulmonary artery ,Cardiology ,Female ,Stents ,business ,Tomography, X-Ray Computed ,Artery ,Dilatation, Pathologic - Abstract
Extrinsic compression of the left main coronary artery (LMCA) secondary to pulmonary artery dilatation is a rare syndrome. Most cases of pulmonary artery hypertension but no atherosclerotic risk factors rarely undergo coronary angiography, and hence, diagnoses are seldom made and proper management is often delayed in these patients. We describe a patient that presented with pulmonary hypertension, clinical angina, and extrinsic compression of the LMCA by the pulmonary artery, who was treated successfully by percutaneous coronary intervention. Follow-up coronary angiography showed patent stent in the LMCA in the proximity of the dilated main pulmonary artery. This case reminds us that coronary angiography and percutaneous coronary intervention should be considered in pulmonary hypertension patients presenting with angina or left ventricular dysfunction.
- Published
- 2013
46. Mid-term results of correction of Tetralogy of Fallot with absent pulmonary valve
- Author
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Shyam S. Kothari, Aabha Divya, Sivasubramanian Ramakriahnan, Shiv Kumar Choudhary, Balram Airan, Rajnish Juneja, Anita Saxena, Saurabh Gupta, and Sachin Talwar
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,RD1-811 ,Adolescent ,Mid term results ,India ,030204 cardiovascular system & hematology ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Internal medicine ,Medicine ,Ventricular outflow tract ,Diseases of the circulatory (Cardiovascular) system ,Humans ,Abnormalities, Multiple ,Cardiac Surgical Procedures ,Child ,Tetralogy of Fallot ,Retrospective Studies ,Retrospective review ,Pulmonary Valve ,business.industry ,Absent pulmonary valve ,Infant, Newborn ,Infant ,Mean age ,Pulmonary artery dilatation ,medicine.disease ,Surgery ,Survival Rate ,Treatment Outcome ,030228 respiratory system ,Airway compression ,RC666-701 ,Child, Preschool ,Cardiology ,Female ,Original Article ,Cardiology and Cardiovascular Medicine ,business ,Echocardiography, Transesophageal ,Follow-Up Studies - Abstract
A bstract Background Tetralogy of Fallot and absent pulmonary valve (TOF/APV) is associated with significant pulmonary artery dilatation and airway compression. Methods We performed a retrospective review of 73 consecutive patients who underwent repair for TOF/APV between January 2005–August 2015. Mean age was 6.4 ± 5.6 years (28 days–22 years). The right ventricular outflow tract (RVOT) was reconstructed using varied techniques. Freedom from RVOT gradients and re-operation was studied. Results There were four (5.5%) early deaths, two each in infants and older children. Median ICU stay was 2 days (range, 1–12 days). Mean ICU stay for, infants, children and adults, was 6.5 ± 6.04, 2.75 ± 2.45, and 2.33 ± 1.03 days, respectively (p = 0.0762). Median hospital stay was 6 days (range, 4 to 15 days). Mean hospital stay for, infants and children and adults was 7 ± 2, 6.75 ± 2.39, and 6.33 ± 1.63 days, respectively (p = 0.325). Mean follow up was 65 ± 36.6 months (median 56 months, range 7–126 months). On follow up echocardiography, 14 (21.21%) had no pulmonary regurgitation. 21 (31.81%) had mild PR patients, 8 (12.12%) moderate PR and 19 (28.78%) had severe PR. There were five (7.5%) reoperations. Five and ten-year survival was 95% ± 2.12 and 92.3% ± 3.45 respectively. Freedom from RVOT reoperation was 93 ± 2.62% and 89 ± 3.87% at 5 and 10 years. Conclusions In contrast to children and adults with TOF/APV, infants carry significant early mortality. But the mid-term outcome for patients who survive the initial repair of TOF/APV is acceptable. However, these patients require constant surveillance and irrespective of the methods of RVOT management, the reoperation rates are expected to be high as more of these patients survive into adulthood.
- Published
- 2016
47. Pulmonary artery dilatation: an overlooked mechanism for angina pectoris
- Author
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Roxana Enache, Catalina Ungureanu, Carmen Ginghina, Dan Deleanu, P. Platon, and Bogdan A. Popescu
- Subjects
Coronary angiography ,medicine.medical_specialty ,Hypertension, Pulmonary ,Pulmonary Artery ,Extrinsic compression ,Angina Pectoris ,Lesion ,Angina ,medicine.artery ,Internal medicine ,Humans ,Medicine ,Thromboembolic pulmonary hypertension ,business.industry ,Coronary Stenosis ,General Medicine ,Pulmonary artery dilatation ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,Pulmonary artery ,Cardiology ,Female ,Stents ,Radiology ,medicine.symptom ,Pulmonary Embolism ,Cardiology and Cardiovascular Medicine ,business ,Dilatation, Pathologic ,Artery - Abstract
Dilatation of the pulmonary artery may lead to the compression of adjacent structures. Of those, the extrinsic compression of the left main coronary artery is the most worrisome. We present the case of a 48-year-old woman who was diagnosed with pulmonary artery dilatation due to severe, thromboembolic pulmonary hypertension. She also had angina and coronary angiography revealed a 70% ostial stenosis of the left main coronary artery. The presence of this isolated lesion in a young woman without risk factors for atherosclerosis suggests extrinsic compression of the left main coronary artery by the dilated pulmonary artery as the likely mechanism. The patient underwent direct stenting of the left main coronary stenosis with a good result. J Cardiovasc Med 9:747–750 Q 2008 Italian Federation of Cardiology.
- Published
- 2008
48. Pulmonic Valve: Pulmonic Regurgitation
- Author
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Kevin Emmerich, Daniel Eum, and Connor A. King
- Subjects
medicine.medical_specialty ,business.industry ,Regurgitation (circulation) ,Pulmonary artery dilatation ,Graham Steell murmur ,medicine.disease ,Pulmonary hypertension ,Connective tissue disease ,humanities ,medicine.anatomical_structure ,Right ventricular hypertrophy ,Internal medicine ,Pulmonary valve ,medicine ,Cardiology ,Pulmonic regurgitation ,medicine.symptom ,business ,health care economics and organizations - Abstract
This chapter will discuss the auscultatory manifestations of pulmonary regurgitation (PR). PR can be caused by a variety of conditions (e.g. pulmonary hypertension, pulmonary valve trauma, and pulmonary artery dilatation), and may be difficult to differentiate from aortic regurgitation. The chapter will also discuss the prognostic implications of pulmonary regurgitation.
- Published
- 2015
49. Aneurisma de artéria pulmonar como manifestação da doença de Behçet
- Author
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Luiz Pedro Meireles, Paulo Manuel Pêgo-Fernandes, Renata Teixeira Ladeira, and Marcos Naoyuki Samano
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,lcsh:Internal medicine ,DOAJ:Medicine (General) ,Hipertensão pulmonar ,lcsh:Specialties of internal medicine ,lcsh:Medicine ,Disease ,behcet's syndrome ,DOAJ:Internal medicine ,hemoptysis ,lcsh:RC581-951 ,pulmonary artery ,pulmonary hypertension ,Medicine ,Surgical treatment ,lcsh:RC31-1245 ,lcsh:RC705-779 ,Aneurisma ,business.industry ,Behcet disease ,lcsh:R ,Artéria pulmonar ,Pulmonary artery dilatation ,lcsh:Diseases of the respiratory system ,medicine.disease ,Pulmonary hypertension ,Surgery ,Hemoptise ,aneurysm ,Síndrome de Behçet ,business ,DOAJ:Health Sciences - Abstract
A doença de Behçet pode ser acompanhada de manifestações pulmonares, às vezes letais se não tratadas adequadamente. Descreve-se o caso de um homem de 53 anos com história de episódios de aftas orais e febre havia vários anos, dois quadros febris prolongados nos últimos dois anos, uveíte tratada com corticóide havia 21 meses, hemoptise havia um mês e emagrecimento de 7kg. Ao exame físico apresentava aftas orais, pseudofoliculite e turvação visual. Os estudos radiológicos evidenciaram dilatação aneurismática de artéria pulmonar. Tratado com corticóide, foi feita lobectomia inferior esquerda e o exame anatomopatológico foi compatível com arterite de artéria pulmonar. O paciente foi tratado com clorambucil por oito meses e mantém-se bem, decorridos 18 meses da cirurgia.
- Published
- 2002
50. Aortic and left pulmonary artery dilatation: an unusual cause of a left hilar mass and lung collapse
- Author
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Adeniji-Sofoluwe, Adenike Temitayo and Hafiz, Atiku
- Subjects
Aged, 80 and over ,Male ,Pulmonary Atelectasis ,lcsh:R5-920 ,lcsh:Public aspects of medicine ,Aorta, Thoracic ,lcsh:RA1-1270 ,lung collapse ,Pulmonary Artery ,Images in Medicine ,aorta ,Mediastinal Cyst ,pulmonary artery dilatation ,Pulmonary artery dilatation, lung collapse, aorta ,Edema ,Humans ,Radiography, Thoracic ,lcsh:Medicine (General) ,Dilatation, Pathologic - Abstract
An 80 year old clergy, presented with a 5-day history of left-sided chest pain which was non-radiating but had cough productive of white sputum. No history of haemoptysis, dyspnoea, orthopnoea or paroxysmal nocturnal dyspnoea was elicited. However, a history of smoking 2 cigarettes per day for 10 years was present. He is a known hypertensive on medications,also being managed for diverticulosis and Benign Prostatic Hypertrophy.Respiratory rate was 26cycles per minute with crepitations in the left mid-and lower lung zones. Bilateral pedal oedema was found but the cardiovascular and gastrointestinal systems were normal. Requests for an ultrasound, a chest X-rayCXR and Contrast Enhanced computerised tomography CECT of the chest were made. High resolution CECT of the chest was performed with a 64-slice Toshiba CT. Multiplanar images in axial, coronal and sagittal planes were acquired at 1mm cuts in pre-and post-contrast series. Images depicting the abnormality are shown (A, B, C,D). No further invasive workup like a biopsy was indicated following imaging. Prior to the CECT, bronchogenic CA was considered in view of the long standing smoking history. The role of Computerised tomography in the evaluation of chest symptoms has been emphasised in these images.
- Published
- 2014
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