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A gray zone in the literature: indications, options, and outcomes for surgical repair of pulmonary artery aneurysms

Part of: Surgery

Published online by Cambridge University Press:  02 December 2021

Ergin Arslanoglu ,
Kenan Abdurrahman Kara Open the ORCID record for Kenan Abdurrahman Kara [Opens in a new window] ,
Fatih Yigit ,
Cüneyt Arkan ,
Esra Ozcan ,
Seda Arısut ,
Ufuk Uslu ,
Nihat Cine ,
Eylem Tuncer  and
Hakan Ceyran
Ergin Arslanoglu
Affiliation:
Pediatric Cardiovascular Surgery Department, Kartal Koşuyolu High Speciality Educational and Research Hospital, İstanbul, Turkey
Kenan Abdurrahman Kara*
Affiliation:
Pediatric Cardiovascular Surgery Department, Kartal Koşuyolu High Speciality Educational and Research Hospital, İstanbul, Turkey
Fatih Yigit
Affiliation:
Pediatric Cardiovascular Surgery Department, Kartal Koşuyolu High Speciality Educational and Research Hospital, İstanbul, Turkey
Cüneyt Arkan
Affiliation:
Pediatric Cardiovascular Surgery Department, Kartal Koşuyolu High Speciality Educational and Research Hospital, İstanbul, Turkey
Esra Ozcan
Affiliation:
Pediatric Cardiovascular Surgery Department, Kartal Koşuyolu High Speciality Educational and Research Hospital, İstanbul, Turkey
Seda Arısut
Affiliation:
Anaesthesia and Reanimation Department, Kartal Koşuyolu High Speciality Educational and Research Hospital, İstanbul, Turkey
Ufuk Uslu
Affiliation:
Anaesthesia and Reanimation Department, Kartal Koşuyolu High Speciality Educational and Research Hospital, İstanbul, Turkey
Nihat Cine
Affiliation:
Pediatric Cardiovascular Surgery Department, Kartal Koşuyolu High Speciality Educational and Research Hospital, İstanbul, Turkey
Eylem Tuncer
Affiliation:
Pediatric Cardiovascular Surgery Department, Kartal Koşuyolu High Speciality Educational and Research Hospital, İstanbul, Turkey
Hakan Ceyran
Affiliation:
Pediatric Cardiovascular Surgery Department, Kartal Koşuyolu High Speciality Educational and Research Hospital, İstanbul, Turkey
*
Author for correspondence: K. A. Kara, MD, Associate Professor, Pediatric Cardiovascular Surgery Department, Kartal Koşuyolu High Speciality Educational and Research Hospital, Denizer street no: 2, Kartal, 34865İstanbul, Turkey. Tel: +905300655225. E-mail: [email protected]
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Abstract

Pulmonary artery aneurysms are rare. They are characterised by an aneurysmatic dilatation of the pulmonary vascular bed, including the main pulmonary artery or the accompanying pulmonary artery branches. Increases in pulmonary flow and pulmonary artery pressure increase the risk of rupture: when these conditions are detected, surgical intervention is necessary.

This study is a retrospective analysis of 33 patients treated in our paediatric cardiac surgery clinic from 2012 to 2020. Aneurysms and pseudoaneurysms in patients who were patched for right ventricular outflow tract reconstruction and corrected with a conduit were excluded from the study. Seventeen (51.5%) of the patients included in the study were female and 16 (48.5%) were male. The patients were aged between 23 and 61 years (mean 30.66 ± 12.72 years). Graft interpositions were performed in 10 patients (30.3%) and pulmonary artery plications were performed in 23 patients (69.7%) to repair aneurysms. There was no significant difference in mortality between the two groups (p > 0.05).

Pulmonary artery aneurysm interventions are safe, life-saving treatments that prevent fatal complications such as ruptures, but at present there is no clear guidance regarding surgical timing or treatment strategies. Pulmonary artery interventions should be performed in symptomatic patients with dilations ≥5 cm or asymptomatic patients with dilations ≥8 cm; pulmonary artery pressure, right ventricular systolic pressure, and pulmonary artery aneurysm diameter must be considered when planning surgeries, their timing, and making decisions regarding indications. Experienced surgical teams can achieve satisfactory results using one of the following surgical techniques: reduction pulmonary arterioplasty, plication, or graft replacement.

Keywords

Pulmonary artery aneurysmssurgical repairplicationpulmonary arterioplasty
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 10 , October 2022 , pp. 1638 - 1643
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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